A 4 mm-Long Implant Rehabilitation in the Posterior Maxilla with Dynamic Navigation Technology: A Case Report after a Three-Years Post-Loading Follow-Up

• Main Authors: Gerardo Pellegrino, Giuseppe Lizio, Fabio Rossi, Lorenzo Tuci, Lorenzo Ferraioli, Luigi Vito Stefanelli, Stefano Di Carlo, Francesca De Angelis
• Format: Article
• Language: English
• Published: MDPI AG 2021-09-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: ultra-short implants; computer-aided implantology; dynamic navigation
• Online Access: https://www.mdpi.com/1660-4601/18/18/9808
• ISSN: 1661-7827; 1660-4601

The use of short (<8 mm long) and ultra-short (<6 mm long) implants allows the prosthetic rehabilitation of the posterior ridges of the jaws avoiding reconstructive procedures. Nevertheless, this approach requires vast experience to ensure the primary stability of the fixture in a correct position. Computer-aided implantology (CAI) achieves better results than the free-hand one in terms of placement accuracy, reducing the surgical risks and the operative timings. Dynamic navigation (DN) allows the surgeon to track the position and movements of the drill in real-time on the CT imaging data set. It is more versatile than the computed static system, enabling the operator to change the guidance coordinates according to the intra-operative feedbacks. A mono-edentulous upper right first molar site was rehabilitated with a four mm-long implant to avoid reconstructive techniques, drastically rejected by the patients. The case was managed within a DN protocol considering the minimal available bone and the prosthetic demands. The phases of this procedure were strictly documented up to a 3-year follow-up. No intra-operative problems occurred, and adequate primary stability of the implant was obtained. The prosthetic loading was carried out within only six weeks without any complications. No variation of the baseline clinical scenario as evidenced clinically and radiographically at the end of follow-up. No similar cases are reported in the literature.