Treatment planning using 3-dimensional computerized tomographic (CT) scans was developed not only to improve the accuracy of implant placement but also to accelerate the treatment protocol. The scientific literature on the survival of implants placed in the pterygoid region is similar to other alternatives in this region. This case report describes the full arch implant reconstruction of a patient with atrophic maxilla using computer guided surgery. A 55-year-old Hispanic female presented to the prosthodontics clinic of NSU in order to get fixed dental treatment. She was wearing maxillary complete denture for more than 15 years and was complaining of loose denture fit and limited function. After clinical examination and taking the 3-dimensional CBCT, atrophic bone was seen in maxilla. Based on the amount of available bone, it was decided to use narrow implants and adding two pterygomaxillary implants to avoid cantilever and giving the prosthesis better stability. In order to have the accurate placement of the implants, mucosa level computed guided surgery was used by planning seven implants including two pterygomaxillary implants. A new denture was made to be converted on the same day of the surgery, so she had the teeth on the day of the surgery. The surgery was done under local anesthesia without raising any flap with minimum bleeding and post-op complications. The conversion was done on a same day after implant placement. Patient left the clinic with the fixed detachable complete denture. One-week post-op evaluation was done, and patient had minimum discomfort. In three-week post-op evaluation, there was no swelling, bruise or pain. The final acrylic teeth reinforced with metal bar was fabricated and inserted 15 weeks after the surgery. All implants were in perfect condition even-though they were narrow platform. Upon 18-months follow up, patient was satisfied with esthetic, phonetics, and function. The mucosa level guided implant surgery is a viable treatment modality with minimum amount of trauma. The use of Pterygomaxillary implants is a great solution when the maxillary bone is atrophic. Teeth in the same day gives immediate function, esthetic, and shorter treatment time which could be of a great benefit to the patient.
Learning Objectives:
Upon completion, participants will be able to understand the step by step procedure of the full arch computer guided implant surgery including placing pterygomaxillary implant in atrophic maxilla.
Upon completion, participants will be able to learn the technique of how to do the same day teeth and conversion on the day of the surgery.
Upon completion, participants will be able to get the idea of doing full arch implant surgery in a shortest time with minimum amount of trauma to the soft tissue and without opening the flap.
