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Updated: Aug 16, 2025

Designing CAD/CAM Surgical Guides for Maxillary Reconstruction Using an In-house Approach
Published on: August 24, 2018
Fabrication of immediately loaded implant-retained maxillary overdenture with flapless surgery using a CAD/CAM
Ilser Turkyilmaz1, Joanna Nicolette Gavras2
1Professor, New York University College of Dentistry, Department of Prosthodontics, New York, USA.
Abstract:
This report describes a digital workflow and two-year follow-up of an immediately loaded implant-retained overdenture using flapless surgery and a computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guide. A prosthetically-driven approach, utilising a three-dimensional (3D) planning software and a CAD/CAM surgical guide, was used to place four implants in the edentulous maxillary arch of a 59-year-old male patient. All four implants were inserted through the surgical guide without raising soft tissue flaps. After placement, the patient was delivered an immediately loaded maxillary overdenture. Surgical implant placement was well tolerated by the patient, who reported no discomfort. Following a four-month period, a new implant-retained maxillary overdenture reinforced by a metal framework was fabricated and delivered to the patient. There were no adverse issues noted with neither the implants nor the maxillary overdenture during the two-year follow up period. The technique using the workflow described in this report may be a predictable and affordable alternative in the restoration of edentulous arches as compared to full-arch fixed restorations.

