Practical Tips for Full Arch Dental Implant Reconstruction

Full arch dental implant rehabilitation has been extensively documented as a successful long-term fixed solution for patients with terminal dentition for both Jaw ArchesFull arch dental implant rehabilitationterminal dentition, Jaw Arches. This process is marketed by many names such as All on 4, All on X, Implant Supported Immediately Loaded Fixed Denture, and/or Teeth in a Day. The optimal long-term success of this treatment requires a multidisciplinary, diagnostically driven treatment planning and execution between an oral and maxillofacial surgeon, a prosthodontist, and a qualified laboratory technician. Most of the surgical complications are related to traumatic removal of the terminal dentition, mishandling of the subperiosteal flaps, damage to inferior alveolar nerve (IAN) vascular bundlesInferior alveolar nerve (IAN) vascular bundles, inadequate enucleation, and curettage of the jaw infection present, loss of implants into the maxillary sinus,Full arch dental implant rehabilitationmaxillary sinus or not diagnosing oral pathological lesions in the pretreatment planning phase. Using original fixtures for the chosen implant systemFull arch dental implant rehabilitationimplant system and new drills for the implant osteotomiesImplant osteotomies is necessary to decrease the chance of bone overheating and not a perfect fitting of the prosthetic parts. Prosthetic complicationsFull arch dental implant rehabilitationprosthetic complications will occur because of a too-conservative vertical reduction and irregular alveoloplastyJaw alveoloplasty of the jaw archesVertical reduction and irregular alveoloplasty of the jaw arches to allow for enough restorative space for the strength of the prosthesis and inadequate anterior-posterior spread of the implants, improper angulation of the implant axis to allow the emergence profiles of the multiunit abutments to come as close as possible to the mid arch of the prosthesisFull arch dental implant rehabilitationmid arch of the prosthesis. A non-passive impression technique or forced denture fitting will cause unequal distribution of the implant forces. It may overload some of the implants during the healing time, causing bone loss and loss of implants in the long term. Perfect fit to all abutments and high rigidity within the framework is required, as it allows for even distribution of loading forces and casting the implants during the healing phase. Preventing many of these complications can be achieved using the technological advances of Digitally and Prosthetically Driven Surgical treatment pre-planningDigitally and Prosthetically Driven Surgical treatment pre-planning, utilizing scanned denture Standard Tessellation Language (STL)Standard Tessellation Language (STL) files onto the cone-beam computed tomography (CBCT) surgical treatment plan, and precise implant placement using minimally invasive robotically assisted implant placement technology or pre-planned guided surgery with stents. Medically compromised patients, heavy smokers, and patients with suboptimal manual dexterity to care for their implants should not undergo this elective procedure because of the high chance of failure and peri-implantitis-associated complications.