Case Studies

Guided Revision & Immediate Function

Before: Failure of five (5) existing implants with significant peri-implant bone loss.

Procedure:

Atraumatic Explantation: Removal of failing fixtures and radical debridement of inflammatory tissue.
TrueGuide® Stackable Precision: Sequential, interlocking guides used to navigate bone defects and ensure anatomically driven placement.
Glidewell HT™ Placement: High-tapered implants utilized to achieve the $>35$ $N \cdot cm$ primary stability required for immediate loading.
Simultaneous GBR: Hard tissue augmentation to resolve residual defects and reinforce the alveolar housing.

After: Delivery of a screw-retained, fixed temporary prosthesis. Immediate restoration of aesthetics and vertical dimension in a single guided appointment.

Guided Full-Arch Immediate Load

Protocol: Seven (7) extractions and immediate placement of six (6) Implant Direct™ Legacy™/Interactive™ fixtures using the TrueGuide® Stackable system.

Exodontia & Debridement: Atraumatic extraction of 7 non-retainable teeth followed by radical site debridement.
TrueGuide® Precision: Sequential, interlocking stackable guides utilized to navigate extraction sockets and ensure anatomically driven fixture positioning.
Legacy™/Interactive™ Placement: Strategic placement of 6 high-stability Implant Direct™ fixtures. The aggressive thread geometry was leveraged to achieve the required primary stability ($>35$ $N \cdot cm$) for immediate loading.
Simultaneous GBR: Bone grafting of residual extraction voids to preserve alveolar volume and buccal plate integrity.
Immediate Provisionalization: Delivery of a screw-retained, fixed temporary prosthesis for immediate aesthetics and functional recovery.

Result: Predictable, single-visit transition from terminal dentition to stable, fixed restoration.

Guided Implant Replacement with Straumann® Implants

Powered by TrueGuide Digital Planning
This case involved the removal of failing dental implants and the precise placement of new Straumann® implants using a fully guided surgical workflow developed with TrueGuide digital planning.
Using CBCT imaging and digital intraoral scans, a prosthetically driven treatment plan was created to ensure ideal implant positioning based on the final restorative outcome. This approach helps support proper emergence profile, occlusion, and long-term function.
A custom surgical guide was fabricated from the digital plan to help control implant angulation, depth, and position during surgery. After careful removal of the failing implants and site debridement, guided osteotomies were performed following the Straumann drilling protocol. New implants were then placed with excellent primary stability and optimal restorative positioning.

Maxillary NobelActive® Guided Full-Arch Immediate Load

Surgical Protocol: Maxillary rehabilitation featuring seven (7) atraumatic root extractions and immediate placement of six (6) NobelActive® fixtures via TrueGuide® Stackable technology.

Maxillary Exodontia & Debridement: Atraumatic extraction of 7 non-retainable maxillary roots; radical debridement of inflammatory/granulated tissue to establish a sterile surgical field.
TrueGuide® Stackable Precision: Sequential, interlocking guide system utilized to navigate extraction sockets and optimize available bone volume with 3D precision, ensuring accurate trajectory in the maxillary arch.
NobelActive® Placement: Strategic placement of 6 NobelActive® fixtures. The unique variable thread profile and apical design were leveraged to achieve high primary stability ($>45\text{--}70$ $N \cdot cm$) in soft maxillary bone.
MUA Integration: Application of Multi-Unit Abutments (MUA) to correct angulation, bypass the maxillary sinuses where necessary, and provide a stable, screw-retained restorative platform.
Simultaneous GBR: Guided Bone Regeneration of residual extraction voids to preserve the facial plate and maintain the maxillary alveolar housing.
Immediate Provisionalization: Delivery of a screw-retained, high-impact temporary prosthesis for immediate aesthetics and functional recovery.

Clinical Result: Predictable, single-visit transition from terminal maxillary roots to a stable, fixed restoration using a high-torque, guided protocol.

Maxillary Guided "All-on-4" with Zimmer Biomet

Exodontia & Debridement: Atraumatic extraction of all remaining maxillary teeth followed by radical debridement of the alveolar sockets to eliminate inflammatory tissue.
TrueGuide® Stackable Precision: Digital planning and sequential interlocking guides used to navigate the maxillary anatomy, ensuring optimized fixture trajectory and maximized A-P spread.
Zimmer Biomet TSV™ Placement: Strategic placement of four (4) Tapered Screw-Vent® fixtures. The friction-fit internal hex and aggressive thread profile were leveraged to achieve the primary stability necessary for immediate loading.
MUA Integration: Utilization of Multi-Unit Abutments (MUA) to correct for posterior tilts, bypass the maxillary sinuses, and establish a common restorative path of insertion.
Alveolar Augmentation: Simultaneous Guided Bone Regeneration (GBR) to address residual extraction voids and preserve facial plate volume.
Immediate Provisionalization: Delivery of a screw-retained, high-impact temporary prosthesis, providing the patient with immediate aesthetics and functional recovery.

Clinical Result: A predictable, single-visit transition from terminal maxillary dentition to a stable, fixed screw-retained restoration.