A Novel Approach for Immediate Implant-Based Oral Rehabilitation in a Sjögren's Syndrome Patient Using Virtual Surgical and Prosthetic Planning.

Patients with Sjögren syndrome (SS) experience difficulties in wearing conventional dentures. After removal of all teeth, the oral rehabilitation is challenging and time consuming using conventional treatment protocols. Although implant-retained overdentures are beneficial for this specific patient group, the average total oral rehabilitation time (TORT) usually takes at least 9 months and needs to be reduced to increase patients' quality of life (QoL). In this paper, we report on a new treatment concept for immediate implant-based oral rehabilitation in a 77-year-old patient with partial edentulous SS. Because of persistent pain, discomfort, and retention problems with the conventional prosthetic devices, full clearance of the remaining mandibular dentition and immediate oral rehabilitation with an implant-retained overdenture were suggested. The treatment protocol included virtual surgical planning (VSP), combining a guided bone reduction of the mandibular alveolar process, immediate dental implant placement, and restoration using a prefabricated bar and placement of the overdenture. This method demands the use of ionizing 3D imaging optionally combined with an optical dental scan or a conventional impression. Furthermore, one needs to gain experience using VSP software. This novel treatment concept for immediate implant-based oral rehabilitation using VSP proved to be feasible and safe in a patient with SS, resulting in a significantly reduced TORT and improved QoL. Further research is needed to what extent this treatment concept could be beneficial to other patient groups, such as patients with head and neck cancer.

Digital implantological workflow for a CAD/CAM immediate long-term temporary restoration for the edentulous maxilla.

The rehabilitation of the edentulous jaw using angulated implants and screw-retained retrievable fixed prosthetic dentures is a well-established treatment method. Possible advantages include the option to avoid bone augmentation, to provide an immediate long-term provisional restoration, and, where appropriate, to perform a minimally invasive procedure. A variety of prosthodontic solutions are available for the definitive restoration, not least allowing the patient's financial situation to be accommodated. Implementing this concept requires systematic planning and an exacting surgical procedure. It makes sense to rely on a computer-assisted process for this purpose as it standardizes the procedure and makes it reproducible, with all the benefits this entails. The present report highlights the consistent integration of virtual planning and computer-aided design/computer-aided manufacturing (CAD/CAM), from the surgical template to the immediate long-term provisional restoration. The relevant procedures are described in general terms and illustrated by a patient case.