Clinical case report: Immediate full-arch implant placement and loading technique using a fiducial-free dynamic...

Dynamic navigation guided surgery requires the use of fiducial markers on teeth to plan for dental implant placement. This poses a significant challenge when all the teeth need to be extracted and bone reduction is needed. This report describes a novel technique to overcome this limitation and perform bone reduction accurately using dynamic navigation. A 61-year-old patient presented with non-restorable maxillary teeth with root caries and generalized periodontitis grade IV stage B. The patient had a reverse smile line with supra-eruption of maxillary right and left premolars. The patient was treatment planned for the extraction of all maxillary teeth, alveoloplasty, and placement of six implants in the first molar, first premolar, and lateral incisor sites for a fixed complete denture prosthesis. A prosthetically-driven guide for a dynamic navigation system was used to place dental implants, perform alveoloplasty, and immediately load the provisional prosthesis. The guide marked planned alveoloplasty level and precluded the use of an X-Clip, overcoming limitations of using dynamic navigation in full arch implant treatments.