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Dynamic navigation and intra-oral photogrammetry for the immediate full-arch rehabilitation of a severely resorbed maxilla: a case report Aly Virani Aesthetic Update 2025 2:1, 41-44.
Authors
AlyVirani
BDS (Hons), Dip MJDF(RCSEng), Assoc FCGDent, Dip Imp Dent RCSEd, MSc (Clinical Oral Implantology), Implant Dentist and Clinical Director, North Cardiff Dental and Implants, Cardiff, Wales
A 69-year-old female patient with osteoporosis and severely resorbed maxilla presented with unrestorable caries, porcelain fracture, and multiple apical infections on the root-treated abutments of a 10-unit maxillary bridge. The treatment plan comprised bilateral pterygoid implants, incisive canal placement of a wide-diameter implant, and bilaterial tilted implants. The surgery was planned to use Navident EVO dynamic navigation system. Accurate placement of all implants was achieved, including the technique-sensitive pterygoids. High primary stability enabled immediate loading, with photogrammetry used to produce a provisional prosthesis. All implants integrated successfully, with the final restoration fitted 4 months post-surgery.
CPD/Clinical Relevance: This is the first documented use of dynamic navigation computer aided dental surgery to facilitate the accurate placement of pterygoid implants in the UK to enable immediate full arch rehabilitation of the severely atrophic maxilla.
Article
A 69-year-old female patient with osteoporosis presented with unrestorable caries (UR6), porcelain fracture, and multiple apical infections on root-treated abutments of a 10-unit maxillary bridge. Clinical assessment of the CBCT revealed pneumatized sinuses as well as limited bone width in zone 1 and no bone in zones 2 and 3 (Figure 1). As such, the following treatment plan was formulated using the PATZi protocol:1
On the day of surgery, screws (Ustomed, Tuttlingen, Germany) were placed in the palate to act as a tracing point for the Navident dynamic navigation, as well as to provide a reference point for the laboratory. An ultra-low dose pre-operative CBCT was taken to capture the screw position digitally. The Navident tracer and jaw trackers were then used to register the patient's'anatomy. This digital file was then compared to the pre-operative CBCT to confirm a registered accuracy of 0.1 mm.
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