Case Study: Guided Maxillary Full Arch, Seven Roots to Six Implants
A maxilla with seven non-restorable roots was taken to a fixed provisional in one surgical visit, opposed by a natural mandibular dentition. 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: maxilla, opposed by natural mandibular teeth
Presentation: seven non-restorable roots
Extracted: seven roots
Placed: six implants, with the posterior implants tilted to bypass the maxillary sinuses
Guide: TrueGuide Stackable system, with the base template pinned to bone before extraction
Grafting: residual extraction voids grafted to maintain the facial plate
Abutments: multi-unit abutments, angled on the tilted posterior implants
Loading: immediate, with a screw-retained interim prosthesis against the natural teeth
Surgical visits: one
Surgical Sequence
Reference capture: the base template was seated and pinned to bone before the roots were removed, so the planned position was transferred from the existing dentition and held once the arch was edentulous.
Extraction and site management: the seven maxillary roots were removed, the sockets were debrided, and the residual extraction voids were grafted to maintain the facial plate and the alveolar housing.
Guided placement: six implants were placed through the stacked osteotomy template, recruiting the primary stability an immediate protocol requires from the softer maxillary bone.
Abutment-level conversion: multi-unit abutments were seated at surgery, angled where the posterior implants were tilted to bypass the maxillary sinuses, correcting the divergence into one common path of insertion.
Immediate provisional: a screw-retained interim prosthesis was picked up intraorally on temporary cylinders and delivered the same day against the natural opposing teeth.
Outcome
The arch went from seven non-restorable roots to a fixed screw-retained provisional in a single appointment, and the definitive prosthesis is designed from the same digital plan.
What the Literature Reports
The maxilla is the harder arch for an immediate protocol, because trabecular bone yields lower primary stability than the mandible. Published series report high survival in the maxilla when four or more implants carry the arch, provided primary stability is confirmed at placement.
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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