PMC6854231_01
Oral cavity examination. Severe atrophy of the alveolar mandible.
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The absence of the border between vestibule and oral cavity proper was noted during the clinical examination (Figure 1).
Panoramic view of the CBCT scan. The mandibular canal is traced. The opening of a neurovascular bundle under soft tissue is noted.
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The CBCT scan showed a close position of the mandibular canal with the opening of the inferior alveolar nerve from the mental foramens under soft tissues, which was confirmed by the patient's complaints (Figure 2).
The CBCT scan. Coronal mandibular view. Four implants were placed in the 3.2, 3.4, 4.1, and 4.3 teeth regions. Distal implants are tilted at 29 degrees.
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Four implants are virtually placed, two of which are positioned tilted at 29 degrees due to the lack of available bone (Figure 3).
Fixed surgical guide.
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Fixing pins were placed and the silicone index was removed (Figure 4).
Healing abutments in situ.
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However, due to the fact that a number of implants were placed in the lower incisal canal, it was decided to install only the healing abutments (Figure 5).
SBCT scan with implants in situ.
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The radiographic control was provided (Figure 6).
Removable maxillary- and implant-supported mandibular prosthesis in situ.
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The durability of this design provides contact with a removable denture of the maxilla, so there is no overpressure (Figure 7).
Panoramic view. Radiographic follow-up a year after surgery.
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