Digital planning and static guided surgery in a limited prosthetic space: a clinical case report

Abstract

Dimensional reduction of the alveolar ridge after tooth extraction in the posterior mandible may limit available bone volume and prosthetic space, increasing the risk of improper implant positioning. Digital technologies (CBCT, intraoral scanning, virtual planning, and guided surgery) have enhanced three-dimensional control of the procedure and reduced clinical subjectivity. Objective: To report a clinical case in which digital planning and static guided surgery improved the predictability of a single-tooth rehabilitation in a posterior region with limited bone availability. Case report: A 51-year-old female patient with a root fracture and mobility of tooth 36 underwent extraction. After 12 months, a new CBCT scan and intraoral scan were obtained and superimposed for reverse planning and fabrication of a 3D-printed surgical guide. A 3.75 × 8.5 mm implant was placed using a guided protocol, with an insertion torque of 60 Ncm and an initial ISQ of 75. After five months, the ISQ increased to 80; an intraoral scan with a scan body was performed, and a zirconia crown cemented on a TiBase was fabricated and delivered without the need for occlusal adjustment. Results: Progressive implant stability was observed throughout clinical follow-up, with a functional definitive restoration and no reported complications. Conclusions: This case suggests that integrating digital planning with static guided surgery may support accurate three-dimensional implant positioning and increase the predictability of single-tooth rehabilitations in posterior regions with limited bone availability.

KEYWORDS

Digital planning; Guided surgery; Implant stability; Intraoral scanning; Posterior mandible.