Type of treatment
Clinical Case description
48-year-old female patient, non-smoker, with no relevant medical history reported.
The patient presents the upper incisors with severe periodontal support loss requiring extraction.
Treatment Plan
Realizar las exodoncias de los dientes del sector anterior y a continuación, proceder a la colocación de implantes en posiciones 12 y 22 mediante cirugía trans-alveolar y carga instantánea mediante puente provisional de 12 a 22.
Given the high aesthetic demand, precise planning was required to ensure correct three-dimensional implant positioning, guaranteeing optimal emergence of the screw channels on the palatal side and the final aesthetic outcome following a Prosthesis First approach.
The provisional bridge is requested to be fully fabricated and ready for placement prior to surgery in order to minimize surgical time as much as possible.
Vulkan Digital Planning and Components
The treatment was planned using Vulkan Digital Prosthesis First technology, based on information gathered from the patient’s intraoral scan, photographs, and radiographic study (CBCT).
An optimal prosthetic bridge design was created, and the ideal implant positions were calculated, taking into account bone characteristics, dento-alveolar inclination, and the high aesthetic demands of the anterior region.
Based on this planning, a Vulkan Digital surgical guide without sleeves was designed and manufactured to ensure precise execution of the planned procedure and to guarantee correct drilling orientation.
The bridge from 12 to 22 was fabricated according to the design, the interfaces were cemented, and it was delivered ready for placement.
Surgical Procedure with the Vulkan Digital System
- Atraumatic extraction of the maxillary anterior teeth (12 and 22).
- Preparation of the implant sites in positions 12 and 22.
- Placement of the Vulkan Digital surgical guide without sleeves. Verification of proper seating.
- Transalveolar surgical approach.
- Initiation of the drilling sequence according to the treatment plan, following the guidance of the Vulkan Digital surgical guide.
- Implant placement in positions 12 and 22, with special attention to orientation and three-dimensional positioning.
- Removal of the Vulkan Digital surgical guide.
- Primary stability measurement (insertion values: 12 (75/75) and 22 (75/75).
- Placement of transmucosal abutments in positions 12 and 22.
- Immediate loading with a provisional bridge from 12 to 22.
- Postoperative radiographic control of implant positioning, transmucosal abutment connections, and bridge interfaces.
- Occlusion check, ensuring the entire bridge is out of occlusion. Verification using an acetate shim.
After
