Anatomically guided full arch implant-prosthetic rehabilitations

Aim: The loss of dental elements causes anatomical, functional, aesthetic, and psychological changes that reduce the patient’s quality of life and comfort. This study aims to show how implant-prosthetic restorations with full-arch immediate loading can be appropriately performed by an anatomically guided method. Materials and methods: Two case reports of two male patients aged 69 and 60 years old who needed an implant-prosthetic full arch rehabilitation were documented to describe the surgical treatment. Discussion: Human anatomy is the basis of any surgical treatment, so in oral surgery, the operator must have a detailed knowledge of the loco-regional anatomy of the head-neck district. For this reason, it is essential to know the topographical limits of the noble structures typically found in daily clinical practice to perform a precise surgical act under safe conditions. The validity of a complete dental arch rehabilitation method is emphasized in literature by inserting two axial implants positioned orthogonally to the occlusal plane in the anterior region and two distal implants inclined with a maximum of 30° distally in the posterior region. The literature reports of inclined implants have been proposed as an alternative to traditional protocols in rehabilitating edentulous jaws. All this can be achieved by carefully studying the clinical case at the beginning of the clinical and radiographic examination. In addition, knowledge of the anatomical reference points must be taken as a reference to obtain a method that is reproducible and adaptable to more clinical cases depending on bone mineralization. Conclusion: Although it may seem excessively invasive, this method allows us to obtain optimal and reproducible results. It allows us to exploit not only the biomechanical advantages obtained by the structure of the prosthetic polygon but above all, those biological ones based on knowledge of the physiology of bone remodeling.