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Blue Curved Tubes
  • Writer: Neo Biotech
    Neo Biotech
  • Mar 20
  • 2 min read
Long-term Success Over 7 Years After Full Arch Rehabilitation Using Neo NaviGuide

Case Summary 🔎

Patient Information

  • Age/Gender: 51-year-old Male

  • Systemic Condition: History of Hypertension and under medication


Clinical Findings

  • Tooth Site: Mandible

  • Oral examination: #43 with Grade 3 mobility

  • Diagnosis: Chronic periodontitis


Clinical Summary

The patient presents with a fully edentulous mandibular arch, except for the mandibular right canine (#43), which exhibits Grade 3 mobility. In the maxilla, a six-unit anterior bridge prosthesis is in place, and implant placement has been performed in both right and left posterior region. A full arch prosthetic rehabilitation is planned for the edentulous mandible.


Treatment Plan 

  • Extraction of #43

  • Placement of 8 implants in the mandible using Neo NaviGuide for guided surgery

  • Final restoration with Zirconia crowns


Conclusion

In this case, a fully edentulous mandible was rehabilitated using the Neo NaviGuide system for the placement of 8 implants, followed by guide bone regeneration(GBR). Definitive prosthetic rehabilitation was successfully completed 8 months post-surgery. The patient demonstrated a stable outcome with good function and prognosis over an 7 year follow up.


Case Presentation

1️⃣ Pre-Op

  • The pre-operative panoramic radiograph and intraoral photograph show a fully edentulous mandibular arch, except for #43.

  • #43 exhibits severe mobility (Grade 3) and significant bone loss. Generalized alveolar ridge resorption is evident, indicating the treatment for full-arch implant-supported rehabilitation for function and esthetic restoration.

pre-operative panoramic radiograph

2️⃣ Treatment Plan

  • Neo NaviGuide fabrication

Neo NaviGuide fabrication
  • Neo NaviGuide drilling



3️⃣ Surgery - Full Arch Rehabilitation

  • The Neo NaviGuide was placed in the mouth. The gingiva at the surgical site is removed using Tissue punch for flapless surgery.

  • Initial drilling is performed to assess bone density and ensure accurate positioning for implant placement.


  • To ensure a safe and precise surgery, the guide is stabilized using vertical anchors. The vertical anchors are placed in the bone at positions #35 and #45 are fixed to the appropriate depth and path using a torque ratchet.


  • Step by step drilling is performed while assessing bone density. Bone particles collected during drilling can be used to autogenous bone.

  • Based on the bone density, cortical tapping is performed in dense cortical bone to achieve maximum BIC and optimal fixation.


  • CMI IS-III Active 4.0*10mm implant was placed in the area of #34.

  • Connecting in fixture type vertical anchors to the implants at #34 and #44 to stabilize the Neo NaviGuide.


  • Step by step drilling is possible through the stabilized guide fixed with vertical anchors. CMI IS-III Active 5.5*8.5mm implant was placed in the area of #47. CMI IS-III Active 5.0*6.0m implant was placed in the area of #37.

Step by step drilling is possible through the stabilized guide fixed with vertical anchors.

  • A total of 8 implants were placed at #34, #35, #36, #37, #44, #45, #46 and #47.

  • An incision is made at the surgical site where the ridge is narrow and requires bone grafting.


  • Bone graft is performed using PRF, Regenoss (Allograft) and autogenous bone which collected during drilling. And resorbable collagen membrane was placed over the graft.


  • Healing abutments were connected to the fixtures.


4️⃣ Post-Op

  • Clinical and radiographic examination after surgery.

Intraoral Photograph
Panoramic Radiograph

5️⃣ Final Restoration

  • The final prosthetic restoration was delivered 8 months after surgery.


6️⃣ Follow-Up

[1-Year Follow-Up]


[3-Year Follow-Up]

Panoramic Radiograph

[7-Year Follow-Up]

  • The 7-year follow-up periapical radiograph shows no significant bone loss, indicating long-term success and a favorable prognosis.

 Periapical Radiograph

7️⃣ Clinical Video


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