title: Immediate loading of two freestanding implants placed by computer-guided flapless surgery supporting a mandibular overdenture with magnetic attachments.
abstract: OBJECTIVE
  The present article describes a novel clinical procedure for mandibular overdentures supported by two freestanding implants loaded immediately after placement via computer-guided flapless surgery.
  
  
  METHODS
  A conventional acrylic complete denture was fabricated, and CT scans obtained using the denture as a radiographic guide. Preoperative computer-assisted planning was performed using commercially available software, permitting simulation of implant placement at optimal positions. Using simulation data, a surgical guide was manufactured and used during surgery. The surgical guide was placed and local anesthesia injected for drilling of anchor pins to stabilize the surgical guide. The drilling protocol for each osteotomy site achieved an insertion torque greater than 35 Ncm. Immediately after implant placement, a keeper of the magnetic attachment was connected to each implant, and the magnetic assembly incorporated into the denture. The mucosal surface of the denture around the magnet was relieved to avoid excessive tissue pressure. The patients were instructed to wear the denture in place continually for the following 7 days. After six months of healing and follow-up, a final denture with a metal framework may be fabricated if necessary.
  
  
  CONCLUSIONS
  A novel treatment protocol for immediately loaded implant-supported mandibular overdentures is described in detail. The protocol ensures secure precise and safe implant placement, successful osseointegration, and immediate improvement of oral health-related quality of life for patients with unstable complete dentures.
authors.affiliation: Department of Implant Dentistry, School of Dentistry, Showa University, Tokyo, Japan; Oral Implantology and Regenerative Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Electronic address: dsato.imp@dent.showa-u.ac.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sato
authors.affiliation: Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Kanazawa
authors.affiliation: Oral Implantology and Regenerative Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: You-Kyoung
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan.
authors.forename: Sawako
authors.initials: S
authors.lastname: Yokoyama
authors.affiliation: Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Omura
authors.affiliation: Department of Implant Dentistry, School of Dentistry, Showa University, Tokyo, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Ozeki
authors.affiliation: Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Minakuchi
authors.affiliation: Oral Implantology and Regenerative Dental Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Kasugai
authors.affiliation: Department of Prosthodontics, School of Dentistry, Showa University, Tokyo, Japan.
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Baba
mesh_terms: D003757:Dental Implantation / Q000379:methods*; D015921:Dental Implants; D003828:Denture, Overlay; D006801:Humans; D008280:Magnetics; D008334:Mandible; D025321:Surgery, Computer-Assisted / Q000379:methods*
chemical_list: D015921:Dental Implants
keywords: Flapless surgery; Immediate loading; Implant overdenture; Mandibular; Stereolithographic