Introduction
Edentulism and repeated prosthetic failure remain significant challenges in geriatric dentistry. Implant-supported full-arch rehabilitation has emerged as a predictable solution, particularly when combined with guided surgery and digital workflows. This case illustrates the management of a 60-year-old female patient with long-standing masticatory dysfunction and a history of multiple removable dentures.
Patient Information
- Age/Sex: 60-year-old female
- Chief Complaint: Difficulty in mastication
- Dental History: Multiple removable dentures over several years, with persistent dissatisfaction regarding retention, stability, and function.
Clinical Findings
- Extraoral Examination: Normal temporomandibular joint function, no facial asymmetry.
- Intraoral Examination:
- Residual alveolar ridges with moderate resorption.
- Reduced occlusal vertical dimension.
- Current dentures poorly adapted, with inadequate retention.
- Radiographic Assessment: CBCT revealed sufficient bone volume for implant placement with guided bone reduction.
Diagnostic Assessment
- Primary Problem: Masticatory dysfunction due to prosthetic instability.
- Secondary Factors: Ridge resorption, repeated denture failure, loss of occlusal support.
Treatment Planning
Maxillary Arch
- Guided bone removal to optimize prosthetic space.
- Piezoelectric bone surgery for precise and minimally invasive osteotomy.
- Bone-supported surgical guide for accuracy.
- All-on-5 protocol for full-arch implant-supported rehabilitation.
Mandibular Arch
- Guided bone removal.
- Piezoelectric bone surgery.
- Bone-supported surgical guide.
- All-on-4 protocol for mandibular full-arch rehabilitation.
Restorative Phase
- Multi-Unit Abutment (MUA) insertion for prosthetic alignment.
- Digital impression using intraoral photogrammetry for high-precision capture.
- Fabrication of FP2 screw-retained monolithic zirconia prosthesis, ensuring durability, esthetics, and functional stability.
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