Innovative Approach to Computer-Guided Surgery and Fixed Provisionalization Assisted by Screw-Retained Transitional Implants

Purpose: The objectives of this case series are to describe a novel clinical approach to treat completely edentulous patients and determine its viability. Computer-guided implant planning was used to create a screwretained surgical template (ST) supported by transitional implants and a fixed screw-retained provisional prosthesis supported by the transitional implants at the time of definitive implant placement. Materials and Methods: Five patients with at least one edentulous arch were treated. After the diagnostic tooth setup was performed, a duplicate with radiopaque acrylic resin was fabricated to serve as a surgical template (ST) for the placement of screw-form transitional implants and a radiographic guide (RG). Four transitional implants were strategically placed through the guide where they would not interfere with the future definitive implants. The transitional implants were used to support the RG during computed tomographic scanning. Subsequently, the RG was converted into a second ST based on three-dimensional virtual planning. Eight implants were placed by the computer-guided system, and an immediate prefabricated fixed provisional was connected to the transitional implants. Results: All the implants included in the study achieved primary stability and osseointegrated successfully. For 4 months, the transitional implants served successfully as abutments for the provisional prosthesis. Conclusion: This innovative clinical approach overcomes the limitations of a mucosa/ bone-supported ST by offering fixed, reproducible support for the RG and ST by means of transitional implants. The delivery of a prefabricated screw-retained provisional on transitional implants allows for passive healing and minimum chairside adjustments. Keywords: computer-guided surgery, dental implants, full-arch implant rehabilitation, full-arch fixed provisionalization, transitional implant