Guided Surgery

Case Study 13

CASE DESCRIPTION:

The patient presented with a failed upper dentition, requiring a comprehensive full-arch rehabilitation based on a prosthetically driven approach. Given the extent of the deterioration and the aesthetic demands of the case, careful planning was essential to ensure predictable functional and long-term outcomes. Dr. Nik developed a detailed treatment strategy focused on precise implant positioning, optimal tissue management, and seamless integration between the surgical and restorative phases.

Utilising advanced digital workflows and guided surgery, Dr. Nik meticulously planned and placed six Conelog Progressive implants from BioHorizons in ideal three-dimensional positions. This prosthetically guided approach ensured optimal implant angulation, distribution, and stability, creating a strong foundation for both the provisional and definitive restorations. To further support bone preservation and regeneration, MinerOss allograft was strategically placed within the extraction sockets, promoting volume maintenance and enhancing biological healing.

A key component of this case was the enhancement of the peri-implant soft tissues. To improve both the thickness and quality of the surrounding gingiva, Dr. Nik harvested connective tissue grafts from the tuberosity. These grafts were carefully adapted and stabilised around the implants, providing increased tissue volume and contributing to improved long-term stability, aesthetics, and resistance to recession.

During the provisional phase, a printed titanium-reinforced composite restoration was utilised to provide immediate function and aesthetics. This provisional prosthesis was expertly adjusted by Gosia Ciepiela, a certified dental technician, ensuring an accurate fit, balanced occlusion, and appropriate support for the surrounding soft tissues. This collaborative approach allowed for precise control over both functional and aesthetic parameters from the early stages of treatment.

To further refine the soft tissue architecture, Dr. Nik performed coronal advancement of the gingival tissues using sling sutures positioned around the provisional restoration. This technique enabled controlled repositioning of the soft tissue margins, supporting the development of ideal contours and emergence profiles for the final prosthesis.

Immediately following implant placement and delivery of the provisional bridge, a panoramic radiograph was taken to verify the accuracy of implant positioning and the passive fit of the restoration. The imaging confirmed successful placement and provided a reliable baseline for ongoing monitoring throughout the healing phase.

This case highlights Dr. Nik’s advanced expertise in prosthetically driven implant planning, guided surgical execution, and sophisticated soft tissue augmentation techniques. His collaborative workflow with highly skilled technicians, combined with precise surgical and restorative integration, makes him a trusted referral partner and an excellent mentor for clinicians managing complex implant and soft tissue cases.