Fully Guided Mandibular Full Arch All on 6

548 Rating(s).


Posted on By Maurice Salama In Full Arch & Dentures

Patient presents with failing dentition in mandibular arch. Fully Guided Bone reduction, Implant placement with Ritter Spiral Implants and their new Guided system, Fully Guided Provisional direct to implant. No MUAs utilized. Immediate Functional loading in 5 hours. Comments and thoughts welcome. Dr. Salama

Fully Guided Provisional
Bone Reduction Guide

Bone Reduction performed with Piezo
Tubeless Sleeveless Ritter Guided system


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12 Comments

Immediate Fibrin over bone graft and final suturing to maintain KT and Vestibular depth.

Fibrin over Bone Graft
Sutures before provisional


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Case summary

Immediate Provisional
Case summary


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Mo,

Just a nice body of work - well designed well executed

Cheers,

Richard


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Fabulous case Maurice.......as i understood from placing a healing collars is that the impression was taken after surgery for fabrication of the provisional.....is that so ??? Or it was pre fabricated according to the digital planning prior to surgery ???


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Emad; All pre-planned digitally. The healing abutments placed to simplify suturing while provisional was finalized in the lab. No impressions taken the day of surgery. Regards Mo


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So nice Maurice, state of the art. Was the provisional finalized before surgery? How do you compensate for possible implant deviations to get a good fit of the temporary? Regards!


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Everything you see was done Digitally, pre-planned and pre-printed prior to the surgical date. IF, any deviation with implant location of one or more implants, which would be very rare, then we would open the temp in those locations and reline the temp cylinders to pick those up. Thanks Dr. Salama


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It looks as if you went distal to the mental foramen on both sides with your implants? If so do you do this often? Just curious on current thoughts on this design. In Misch textbooks he talks about only going distal to foramen unilaterally. Would love to get your opinion/thoughts on this concept/design. Dr. Claiborne


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When the plan is for full molar occlusion, I always prefer 6 implants and 2 distal to foramen, 1 on each side. Dr. Salama


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Caso perfectamente bien planificado, cuales son las condiciones dentales del maxilar superior? gracias.


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great planning and executions Mo. Love the workflow. How do you fit the implants to the abutments. I assume you pick up the abutments in the mouth if so how do you position the denture according to the upper teeth so you don't need too much grinding in


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Howie; Thanks, it all predetermined and the temp is pin indexed to the bone and against the opposing arch with a bite registration. All Fully Digitally Guided...more accurate and less time consuming. regards Mo


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