Case Study: Guided Mandibular Full Arch, Seven Extractions and Six Implants
A mandibular arch with seven non-restorable teeth was taken to a fixed provisional in a single surgical visit. Six implants were placed through the TrueGuide Stackable guide system and immediately loaded. TrueGuide Dental planned the case from the CBCT and the intraoral scan and printed the guides.
Case at a Glance
Arch: mandible
Presentation: seven non-restorable teeth
Extracted: seven teeth
Placed: six implants between the fresh extraction sockets, fully guided
Guide: TrueGuide Stackable system on a metal-reinforced base template locked with bone-anchored fixation pins
Grafting: residual extraction voids grafted to preserve alveolar volume and the buccal plate
Abutments: multi-unit abutments seated at surgery
Loading: immediate, with a screw-retained interim prosthesis in occlusion
Surgical visits: one
Surgical Sequence
Reference capture: the metal-reinforced base template was seated on the remaining dentition and locked with bone-anchored fixation pins, so the planned position survived the extractions and carried every template that stacked on it.
Extraction and site management: the seven non-restorable teeth were removed, the sockets were debrided, and the residual extraction voids were grafted to preserve alveolar volume and buccal plate integrity.
Guided placement: six implants were placed through the stacked osteotomy template, threaded between the fresh extraction sockets in prosthetically driven positions, with primary stability confirmed at placement.
Abutment-level conversion: multi-unit abutments were seated at surgery to move the restorative connection above the tissue and establish a common path of insertion.
Immediate provisional: a screw-retained interim prosthesis was picked up intraorally on temporary cylinders and delivered the same day, in occlusion against the opposing arch.
Outcome
The patient left one surgical visit with a fixed screw-retained provisional, and the definitive prosthesis is designed from the same digital plan that produced the guides.
What the Literature Reports
Placing implants between fresh extraction sockets leaves little margin, which is the argument for a pin-fixated template. Meta-analysis of static guided surgery reports mean deviations of 1.2 mm at the entry point, 1.4 mm at the apex and 3.5 degrees in angulation, and consensus guidance is to plan a 2 mm safety margin to adjacent structures on that basis.
Planning and guides by TrueGuide Dental. Surgery performed by the treating clinician.
Plan a Similar Case
Upload the CBCT, intraoral scan and Rx on the Submit a Case page or call (201) 255-4233. Guide packages are on the TrueGuide Pro page, and the other four cases are on the Case Studies page. How a stackable guide keeps one reference through the extractions is covered in Stackable Guides for Full-Arch.
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