Guided Implant Placement with Hard & Soft Tissue Management.

Case Study 9

CASE DESCRIPTION:

The patient presented with a failing upper dentition that required a comprehensive, prosthetically driven full-arch rehabilitation. Given the complexity of the case, a meticulous and digitally guided approach was essential to achieve predictable functional and aesthetic outcomes while preserving as much of the existing anatomy as possible. Dr. Nik developed a detailed treatment plan focused on optimal implant positioning, soft tissue management, and long-term restorative success.

Utilising advanced digital planning and guided surgery protocols, Dr. Nik precisely placed six Conelog Progressive implants from BioHorizons in strategically ideal positions. Notably, this was achieved without the need for bone reduction, preserving the patient’s natural bone structure and supporting improved biological outcomes. Careful attention was given to implant angulation and distribution to ensure a stable foundation for an immediate full-arch restoration.

To enhance healing and support tissue regeneration, MinerOss allograft was placed within the extraction sockets to maintain volume and encourage bone integration. In addition, PRF (Platelet-Rich Fibrin) membranes were utilised to promote accelerated soft tissue healing, reduce inflammation, and improve overall tissue quality during the early stages of recovery.

A key component of the treatment was the provisional phase, where Dr. Nik worked closely with Gosia Ciepiela, a certified dental technician, to refine a printed titanium-reinforced composite provisional restoration. This collaborative approach ensured that both functional and aesthetic parameters were carefully controlled from the outset. The provisional prosthesis was adjusted to provide immediate stability, proper occlusion, and an ideal framework for soft tissue shaping.

To further optimise soft tissue outcomes, Dr. Nik performed coronal advancement techniques using sling sutures around the provisional restoration. This allowed for precise control of tissue positioning, encouraging favourable gingival contours and establishing an ideal emergence profile for the final prosthesis.

Immediately following implant placement, a panoramic radiograph was taken to confirm accurate implant positioning and the passive fit of the provisional bridge. The healing phase was closely monitored, with sutures removed at two weeks and early soft tissue maturation observed by the third week. During this period, the provisional restoration continued to be carefully adjusted to guide tissue adaptation and ensure optimal contour development.