NEO-NAVIGUIDE usage in compromised bone width of All-on-4 case with NEOBIOTECH implant

This case presents full mouth teeth replacement with All-on-4 concept treatment.

Patient information

Healthy Australian female patient, 59 years old, came to BFCdental (Bangkok, Thailand) for making new full mouth teeth replacement. She choose all remaining teeth extraction and All-on-4 concept treatment for her treatment option because of her affordable budget, and she need to complete full mouth treatment within 1 trip, 14 days.

Introduction

This case presents full mouth teeth replacement with All-on-4 concept treatment. We use 4 dental implants and 5 dental implants to support lower & upper fixed hybrid denture. 4 tilted distal implants in all of quadrants had been placed for avoiding anatomical structures. We had used 3D-surgical guide with NEO-NAVIGUIDE kit drilling in upper jaw which is compromised bone width in most of area. After upper implants placement, we use buccal graft with sticky bone & CGF (concentrated growth factor) for guided bone regeneration.

Preoperative Photographs

1st appointment : All remaining teeth extraction & 4 Lower implants placement

2 diameter sizes in 1 Parallel pin

17º Tilted distal implant Q4

2 diameter sizes in 1 Parallel pin

2 diameter sizes in 1 Parallel pin

Multiunit Angled Abutment : Different point of engagement = Different prosthesiss screw hole axis

Closed tray impression technic with Transfer impression coping

GBR with Sticky bone + CGF

After operatio

After 1 day

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2nd appointment : Upper implants placement

In Skeletal Class 2 patient, one of concern is… “Upper front screw access holes on Screw-retained implant restoration”.

Surgical guide + NEO NAVIGUIDE Kit drilling

Surgical guide for upper jaw

Surgical guide for upper jaw

Main concern: Surgical Guide stability during drilling

After 5 dental implants placement with NEO NAVI GUIDE (Surgical guide usage for Proper position of implant placement)

Compromised bone width can be augmented with bone graft materials after placement

3 front dental implants:Multi unit straight abutment 2 distal dental implants:Multi units angled abutment

GBR & Socket grafting with Sticky bone (AFG + particulate bone) & CGF

Open tray impression technic with pick-up impression coping

3rd appointment : Try-in framework & bite registration

Upper jaw: After operation 1 day Lower jaw: After operation 2 days

After operation 1 day

After operation 2 days

Try-in U&L metal framework

Fit checking of U&L metal framework by Panoramic X-ray + Bite registration

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4th appointment : Upper & Lower Teeth Try-in

RE-BITE for mid-line correction

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5th appointment : Upper & Lower Teeth insertion

Upper: After 10 days Lower: After 11 days

Smile line observation

Observe Soft tissue profile & Maxillomandibular angle

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6th appointment : Recheck (after insertion 1 day)

After treatment