title: Flapless CAD/CAM-guided surgery for staged transition from failing dentition to complete arch implant rehabilitation: a 3-year clinical report.
abstract: The transition of patients from failing dentition to complete arch implant rehabilitation often requires that the patient be rendered edentulous and has to wear a complete removable dental prosthesis for varying periods of time. This is objectionable to many patients. A staged treatment approach allows a fixed interim restoration, patient comfort, and prosthodontic control throughout the rehabilitation process. CAD/CAM-guided flapless implant surgery has the advantage of prosthetically driven implant placement and minimal postoperative sequelae. A patient with a failing dentition was treated with this combined protocol and was followed up for 3 years after loading. Implant and prosthesis survival rates were 100%, with no technical complications encountered up to the last recall. The purpose of this clinical report is to describe a combination of CAD/CAM-guided flapless surgery and a staged treatment approach, thereby giving the patient a tooth-supported or implant-supported fixed interim prosthesis during the entire rehabilitation process. The various surgical, laboratory, and prosthetic stages are illustrated for the complete arch prosthetic rehabilitation, and the 3-year follow-up outcome is reported.
authors.affiliation: Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA. panpapaspyridakos@gmail.com
authors.forename: Panos
authors.initials: P
authors.lastname: Papaspyridakos
authors.forename: George Shelby
authors.initials: GS
authors.lastname: White
authors.forename: Kunal
authors.initials: K
authors.lastname: Lal
mesh_terms: D000368:Aged; D017076:Computer-Aided Design; D000044:Dental Abutments; D003731:Dental Caries / Q000628:therapy; D059605:Dental Implant-Abutment Design; D003758:Dental Implantation, Endosseous / Q000295:instrumentation / Q000379:methods; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D003779:Denture Design; D003830:Denture, Partial, Fixed; D003833:Denture, Partial, Temporary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007574:Jaw Relation Record; D007576:Jaw, Edentulous, Partially / Q000534:rehabilitation / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures; D009065:Mouth Rehabilitation / Q000379:methods*; D010347:Patient Care Planning; D010510:Periodontal Diseases / Q000628:therapy; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014584:User-Computer Interface; D014716:Vertical Dimension
chemical_list: D015921:Dental Implants