Comprehensive Digital Workflow and Computer-Assisted Implant Surgery in a Patient with Reduced Crest Width. Case Report of a Split-Mouth Approach

Abstract

Modern treatment protocols in implant dentistry focus on lower morbidity and patient-centered outcomes, in addition to commonly applied treatment success criteria. Prosthetically- driven digital planning followed by static computer-assisted implant surgery (sCAIS) may minimize the need for bone aug-mentation by ideally utilizing the residual crest and thereby improve patient satisfaction. A healthy 37-year-old female suffered from agenesis of both second mandibular premolars and presented wide single-tooth gaps on both sides of the mandible with a moderate (left) and pronounced (right) horizontal bone deficiency. 3D implant planning allowed ideal implant positioning in the residual bone volume while respecting critical anatomical structures. This enabled a flapless sCAIS procedure without bone grafting in the left mandible. On the right side, the insufficient bone volume was augmented simultaneously to the sCAIS using GBR. The clinical and radiographic parameters showed a good oral health status in the 1-year postop examination. The final im- plant position presented a minimal angular and horizontal deviation from the initial planning. The patient was highly satisfied with the two applied methods but preferred the flapless procedure.