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Updated: Apr 2, 2026

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
Published on: October 18, 2021
Digitally milled multifunctional guide for immediate anterior implant placement and provisionalization
Gerardo Mendoza-Azpur1,2, Milton Villanueva Valenzuela3, Jorge Renato Alva Agurto4
1Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA.
None:
This case report describes a digital workflow for immediate implant placement and provisionalization in the maxillary aesthetic zone using a digitally milled multifunctional surgical-prosthodontic guide with an integrated precontoured veneer-type restoration. Intraoral scanning, cone-beam computed tomography, and computer-aided design were combined to fabricate a guide incorporating a polymethyl methacrylate restoration for immediate provisionalization. Simultaneous hard- and soft-tissue management was performed to preserve the facial contour and enhance gingival thickness. The digital plan was reproduced clinically with high fidelity, achieving primary stability and favorable peri-implant soft-tissue architecture. Harmonious aesthetic integration was observed. This digitally milled multifunctional guide provides a precise, efficient, and biologically aligned workflow for anterior implant rehabilitation by unifying guided surgery and immediate provisionalization in a single preplanned procedure.

