A comminuted dento-alveolar fracture with premaxillary dental avulsion. Pilot-drill guided implant-prosthetic rehabilitation: a case report and an overview of guided implant placement

Abstract

In modern dentistry, implantology is widely used; implants have a survival rate of 96.4-96.9% at 10-year follow-up. In order to obtain aesthetic, health, and performance results of implant restorations, virtual pre-surgical prosthetic planning is essential. For proper planning, the patient’s CBCT data is matched to the prosthetic design in order to virtually plan the three-dimensional positioning of the implant before surgery. The patient, following trauma, had avulsion of elements 1.2, 1.1 and 2.1. The fracture is treated conservatively, and after 3 months, three implants are placed with guided Pilot-Drill surgery and prosthetically guided implant design. To achieve a clean transmucosal path and create good aesthetic profiles, the prosthetic connection's depth was adequate. Periodic professional oral hygiene recall has been essential for the long-term maintenance of the implants. At the follow-up of 6 years, perimplant bone stability and aesthetic and functional satisfaction of the patient were detected. In the field of dental implant placement, bone data, and anatomical restrictions can be processed by guided implant software. In combination with wax-up scans, implant planning will improve the predictability of implant placement. The ideal placement of implants in prosthetically guided implantology is not solely determined by bone anatomy but also by the final position and features planned for the prosthesis. A hybrid solution between traditional and total computer-guided surgery is achieved by Pilot-Drill Guided Surgery, which can combine the advantages of fully guided and free-hand approaches. The Pilot Drill Template implantology is a compromise that combines the benefits of fully guided and traditional surgery while also eliminating their limitations.