Immediate full-arch rehabilitation continues to evolve with the integration of digital workflows, guided implant surgery, and photogrammetry. In this case, we present a complete digital protocol for the management of a failing mandibular bridge using fully guided implant placement and immediate loading.
Case Overview
The patient presented with a failing lower fixed bridge requiring extraction and full-arch rehabilitation. The treatment plan involved removal of the failing prosthesis, placement of 6 implants using a fully guided protocol, and immediate loading through a fully digital workflow.
Surgical Phase
The first step involved the removal of the existing failing mandibular bridge followed by atraumatic extraction of the compromised teeth.
Using a fully guided surgical approach, six implants were placed in the mandible. Adequate primary stability was achieved in all implants, with insertion torque values exceeding 35 Ncm, allowing for immediate loading.
Digital Impression and Photogrammetry
Capturing a full-arch implant scan immediately after surgery can be extremely challenging, particularly in the presence of fresh extraction sockets, bleeding, and soft tissue instability.
In this case, digital records were obtained using the Shining 3D Elite Photogrammetry Scanner.
Despite the difficult intraoral conditions, the scanner successfully captured:
-
The mandibular arch
-
The maxillary arch
-
Bite registration
-
Photogrammetry markers
-
Marker alignment
the entire digital scanning process was completed in approximately 90 seconds.
This demonstrates the growing reliability of photogrammetry technology in managing complex full-arch implant cases.
Prosthetic Phase
Following the digital scanning, the prosthetic workflow continued with the fabrication of a milled PMMA full-arch prosthesis.
The provisional prosthesis was delivered using Rosen screws and delivered chairside within 24 hours, allowing the patient to benefit from immediate function and esthetics.
The prosthetic phase was completed under the supervision and guidance of the full-arch rehabilitation expert Abdelrahman Khalaf, whose mentorship was invaluable throughout the case.
Full-arch rehabilitation has entered a new era where guided surgery, photogrammetry, and digital prosthetic workflows can significantly reduce treatment time while maintaining high accuracy.
Cases like this demonstrate how modern digital tools allow clinicians to deliver predictable immediate loading protocols, even in challenging clinical situations.
As digital dentistry continues to advance, one principle remains clear:
High-end scanners deliver high-end results.
Elite results require Elite technology.
Share on:
