Full-Arch Maxillary Rehabilitation in a Geriatric Patient via Bi-Cortical Anchorage (CMI Mechanism) and Early Loading.
Clinical Case Explanation:
This presentation highlights a comprehensive full upper arch rehabilitation for an 86-year-old patient, utilizing Neobiotech implants guided by the Crestal-Middle-Incisal (CMI) implant design philosophy to maximize primary stability in compromised maxillary bone.
Key surgical and prosthetic milestones documented in the sequence include:
Pre-Operative Assessment: CBCT evaluation of the upper jaw showing failing dentition, reduced bone volume, and proximity to the maxillary sinuses.
Atraumatic Extractions ,Immediate Implant Placement and Grafting: Execution of relatively atraumatic extractions followed by the placement of Neobiotech Implant and Alloplast bone graft into the extraction sockets and jumping distances to optimize ridge architecture and defect fill.
Bi-Cortical Engagement: Strategic implant placement achieving engagement across multiple bone zones (crest, middle cancellous bone, and basal cortical layers) to secure robust anchorage.
Loading Protocol: Opting out of immediate loading, the case implemented a healing window with second stage done at 8 weeks as two of the multiunitshad become loose with final restorations delivered at 10 weeks post-surgery.
Long-Term Follow-Up: Final fixed prosthetic delivery resulting in a stable, functional outcome, with 2-year follow-up CBCT scans confirming preserved bone levels and cortical stability.