Use of OneGuide system to place implants avoiding anatomical structures in complete edentulous mandible with severe atrophy
By Su-Bin Kim, Young-Tack Kim
Introduction:
The rehabilitation of a complete edentulous mandible, particularly in cases of severe alveolar bone loss, poses significant challenges in dental implant placement. This case study explores the use of the OneGuide system in the precise placement of dental implants in a 66-year-old female patient with severe atrophy of the mandible. The OneGuide system, coupled with advanced digital planning and 3D printed stents, facilitates accurate implant positioning, ensuring optimal outcomes while avoiding critical anatomical structures. This approach underscores the integration of modern technology in addressing complex dental restoration needs.
Patient Information
- Age / Sex: 66 / Female
- Tooth Number: #43,45,33,35
- CC: Rehabilitation of complete edentulous mandible
- Severe alveolar bone loss in mandible
- Dx: Root rest on #42,31,32
Treatment Plan
Ext. on #42,31,32 and Implantation on i43,45,33,35 using OneGuide for All on 4 concepts
Clinical Procedures
- Preparation of Radiographic Stent:
- A radiographic stent was fabricated using a 3D printer. This stent was designed based on a digitally scanned image of the patient’s existing mandibular denture, ensuring precise adaptation. The stent was positioned in the patient’s mouth for radiographic imaging to aid in pre-operative planning.
- Preoperative Imaging and Planning:
- A panoramic CBCT (Cone Beam Computed Tomography) scan was obtained with the radiographic stent in place to evaluate the underlying bone structure and anatomical landmarks.
- Implant and digital guide planning were carried out using the 3Shape Implant Studio software, which allowed for detailed visualization and planning of implant placement. This digital planning facilitated the precise design of the surgical guide.
- Design and Fabrication of Digital Guide:
- The digital guide was designed using OneGuide technology (Osstem, Seoul, Korea). This guide was customized to match the preoperative plan, ensuring accurate alignment and positioning of the implants according to the planned angles and locations.
- Guided Surgery Using Osstem OneGuide Kit:
- The Osstem OneGuide kit was used during the guided surgery to place the implants. The kit includes components for guiding the drill and ensuring the implants are placed according to the preoperative plan.
- Four Osstem TSII fixtures (4.0x10mm) were precisely placed in the mandibular canines and premolars, corresponding to the planned positions.
- Postoperative Evaluation:
- Clinical Photographs:
- (A) Postoperative clinical photograph showing the implant placement.
- Panoramic Radiograph:
- A postoperative panoramic radiograph confirmed the correct positioning of the implants.
- The patient received a temporary mandibular hybrid denture, and intra-oral photographs were taken to document the immediate outcome.
- Clinical Photographs:
- Outcome and Follow-up:
- The implant placement was executed as per the planned angles, and the patient reported no hypoesthesia or abnormal sensations post-surgery. The procedure resulted in minimized swelling and pain, indicating a successful and well-tolerated implant placement.
Conclusion
- Rehabilitation of complete edentulous mandible (ext #42,, 31, 32)
- Implant placed with planned angle (#45i, 43i, 33i, 35i) with TS II
- No hypoesthesia or abnormal sensation after surgery (Minimized swelling or pain)
