Patient history:

Name: Nora

Age: 50

Gender: Female

Medical history : ASA I – heavy smoker – depression

Dental history: patient loses all of his teeth due to lack of economic resources, currently looking for a more comfortable and aesthetic solution

Reason for consultation: my prostheses move a lot, I need something firm

Initial X-ray – initial clinic

cone beam

Diagnostic wax-up - Occlusion test – neutral canine and molar occlusion

Occlusion test – profile and lip support reestablished

Diagnosis:

• Maxillary and mandibular total edentulousness

Relevant clinical situations

• Class III ridge collapse (Seibert,1983)- Moderate (Allen,1985).

• Heavy Smoker.

Treatment plan:

• Regularization of the alveolar ridge in the maxilla and mandible.

• Surgery of implants in the maxilla: 4 (2 straight and 2 angled) (all on four) + osseodensification with versah burs

• Jaw implant surgery: 4 (2 straight and 2 angled)

• ISIII Active Neobiotech implants

• ROG: InterOSS Demineralized Bovine Bone without organic matrix 1 gr Collagen membrane 15 x 30

• Final rehabilitation type ad modum upper and lower

Semi-strict surgical guide - prosthetic duplicate - test on patient

Surgery – initial center pin

Surgery – upper semi-strict guide positioning

Neobiotech protocol + osseodensification with versah burs

osseodensification with versah burs

final x-ray

Beginning to rehabilitate the jaw - 4 months later

open tray impression

bar test

mandibular occlusion test

final smile

rehabilitative control x-ray