Immediate Loading and Full Mouth Rehabilitation with a 4 Year Follow Up: A Case Report

Abstract

Introduction: Replacement of missing teeth using dental implants have revolutionized the field of dentistry. Digital approach for implant placement has made it easier to place implants in optimal three dimensional position thus reducing prosthetic errors. It is very important to  discuss  the longetivity of the implants which mainly depends on the prosthetic design , type of abutments and material used for loading implants and the prosthetic work flow.

Objectives: The objective of the present case was to achieve a completely passive fitting prosthesis using digital approach and to evaluate the marginal bone loss and longetivity after 4 years of prosthetic delivery .

Methods: Immediate implants were placed after extraction in both the upper and lower arches (6 each arch) using a digitally planned tooth tissue supported guide. The  multiunit abutments were placed over the implants on the surgical day itself followed by immediate loading of the implants with a milled PMMA (Poly methy metha acrylate).The final prosthesis were delivered after 3 months of temporization .This prosthesis was made in multi layered zirconia material. The case was evaluated for marginal bone loss after 4 years.

Results: The surgical guide helped precise placement of the implants with little to no deviation from the planned position. The radiographic evaluation showed minimal or no bone loss around the implants.

 Conclusions: Digital approach for implant placement and prosthetic planning can achieve good passivity for the entire superstructure over the implants and help in long term survival of the same.