:sharpen(level=0):output(format=jpeg)/up/dt/2025/08/Transforming-full-mouth-rehabilitation_header.jpg?ssl=1 "Reworking full-mouth rehabilitation")
Smilecloud is an leading edge virtual instrument that mixes synthetic intelligence with an unlimited library of pure smile designs, enabling the introduction of extremely personalized remedy plans. Its integration with virtual workflows—equivalent to the ones of CBCT imaging, intra-oral scanning and guided implant surgical treatment—streamlines each degree of remedy, from analysis and making plans to execution. Those applied sciences strengthen precision in implant placement and prosthetic design, scale back chairside time and foster higher conversation with sufferers by means of offering them with a transparent figuring out of the proposed results.
On this case, Smilecloud performed a key function in designing a grin that harmonised with the affected person’s facial options whilst addressing her practical priorities. The combo of virtual workflows allowed for the instant placement and loading of implants, making sure a unbroken transition from compromised dentition to solid, implant-supported restorations. The remedy completed a solid and natural-looking consequence, addressing the affected person’s aesthetic issues and restoring her talent to consume conveniently.
:sharpen(level=0):output(format=webp)/up/dt/2025/07/Transforming-full-mouth-rehabilitation_Fig.3.jpg "Fig. 3")
Fig. 3
Preliminary state of affairs
A wholesome 61-year-old feminine affected person with out a vital clinical historical past and who took no medicines and had no identified systemic illnesses or possibility elements equivalent to smoking that might compromise remedy results got here to our sanatorium. She was once involved concerning the mobility of her tooth and their look. She additionally reported discovering it tough to consume correctly, affecting her day-to-day existence. The affected person’s number one center of attention was once making improvements to the aesthetics of her tooth to succeed in a pure look that might supplement her facial options. She additionally prioritised recovery of right kind serve as to consume conveniently with out issue. She was once adverse to dressed in a denture and desired a long-term resolution that might handle her high quality of existence whilst making sure solid tooth and optimum oral well being.
Within the extra-oral exam, a medium smile line was once noticed with distinguished areas between the tooth owing to enamel loss and the presence of black triangles (Figs. 1–3). Intra-orally, the affected person introduced with generalised plaque accumulation and irritation, affecting roughly 30% of the oral hollow space. Periodontal exam published spaces of localised bleeding on probing, indicating lively irritation. Teeth mobility was once obtrusive for a couple of tooth, in step with the affected person’s historical past of periodontal illness.
The affected person wore a detachable recovery within the maxillary arch and introduced with anterior retainers in each the maxillary and mandibular arches owing to enamel mobility led to by means of periodontal illness. Enamel #15, 13, 23, 25, 27, 36, 35, 44, 45, 46 and 47 have been lacking. Moreover, the affected person introduced with a number of dental fillings (Figs. 4–7).
:sharpen(level=0):output(format=webp)/up/dt/2025/07/Transforming-full-mouth-rehabilitation_Fig.4.jpg "Figs. 4–7: The intra-oral examination showed generalised periodontitis, a removable maxillary restoration and multiple missing mandibular and maxillary teeth.")
Figs. 4–7: The intra-oral exam confirmed generalised periodontitis, a detachable maxillary recovery and a couple of lacking mandibular and maxillary tooth.
:sharpen(level=0):output(format=webp)/up/dt/2025/07/Transforming-full-mouth-rehabilitation_Fig.5.jpeg "Fig. 5")
Fig. 5
:sharpen(level=0):output(format=webp)/up/dt/2025/07/Transforming-full-mouth-rehabilitation_Fig.6.jpeg "Fig. 6")
Fig. 6
:sharpen(level=0):output(format=webp)/up/dt/2025/07/Transforming-full-mouth-rehabilitation_Fig.7.jpeg "Fig. 7")
Fig. 7
A CBCT scan was once taken to decide the standard and amount of the bone within the edentulous spaces. The radiographic research confirmed ok bone peak within the spaces of enamel extraction, taking into consideration fast implant placement. The rest bone equipped enough improve for preliminary balance throughout implant placement. Enough horizontal ridge width was once noticed within the doable implant websites, making sure right kind implant positioning with out the will for extra ridge augmentation. Bone high quality was once beneficial for fast implant placement. The anterior maxilla introduced average to excellent bone density (Sort II–III) and the mandible superb bone density (Sort I–II), in particular within the posterior areas, indicating top number one balance for implants. Due to this fact, virtual impressions have been got the use of the TRIOS intra-oral scanner (3Shape) and exported in STL document layout (Figs. 8 & 9).
Remedy making plans
The rest molars within the maxillary arch confirmed doable for preservation and serve as with common periodontal remedy and cautious tracking. Then again, the opposite tooth have been deliberate to be extracted owing to deficient diagnosis, basically led to by means of complex periodontitis and the related serious bone loss (Fig. 10).
The affected person introduced with a hopeless dentition owing to periodontal illness, characterized by means of vital bone loss and enamel mobility. There have been no medical indicators or signs of endodontic involvement or endodontic or periodontic lesions. Then again, a number of tooth have been lacking owing to earlier extractions, and the rest tooth confirmed indicators of structural compromise. The presence of enamel mobility and retainers additional indicated innovative periodontal tissue harm. No proof of root fractures was once noticed clinically or radiographically. The medical findings mirrored the long-term results of periodontal illness and emphasized the will for a complete strategy to repair serve as, aesthetics and oral well being.
To verify exact and predictable remedy making plans, the DICOM recordsdata, STL recordsdata and medical pictures have been seamlessly built-in into Smilecloud, utilising complex synthetic intelligence applied sciences to ship a extremely personalized smile with outstanding precision (Figs. 11–15).
After discussing more than a few remedy choices with the affected person, the verdict was once made to continue with fast implant placement. The provisional restorations have been designed, milled from polymethylmethacrylate and positioned at the similar day to revive serve as and aesthetics.
The remedy workflow incorporated:
- extraction of the hopeless tooth #34, 33, 32, 31, 41, 42 and 43 (16 & 17);
- making plans of implant positioning (18–21);
- introduction of a tooth- and mucosa-supported surgical information to stabilise the drilling, making sure correct three-D positioning of the implants (22–28);
- fast implant placement in positions #34, 32, 42 and 44 the use of Straumann BLX implants (diameter: 4 mm; period: 10 mm);
- placement of a provisional recovery within the mandibular arch;
- extraction of the hopeless tooth #14, 12, 11, 21, 22 and 24;
- fast implant placement in positions #14, 11, 21 and 23 the use of Straumann BLX implants (diameter: 75 mm; period: 12.00 mm);
- guided bone regeneration with a xenograft and resorbable membrane;
- placement of a provisional recovery within the maxillary arch; and
- definitive prosthetic rehabilitation of the maxillary and mandibular arches with screw-retained implant-supported restorations.
Surgical process
The affected person was once given preoperative medicine consisting of two g of amoxicillin taken orally 60 mins sooner than surgical treatment, in response to the usual protocol, and 400–600 mg of ibuprofen taken 30–60 mins previous to surgical treatment. Native anaesthesia was once administrated with 4% articaine mixed with 1:100,000 adrenaline.
For the mandibular arch, the primary surgical information was once checked for right kind are compatible (Fig. 29). The surgical information, supported by means of the tooth, was once positioned, and anchor pins have been inserted (Figs. 30 & 31). After this, the information was once got rid of, and the hopeless tooth have been atraumatically extracted (Figs. 32 & 33).
:sharpen(level=0):output(format=webp)/up/dt/2025/07/Transforming-full-mouth-rehabilitation_Fig.35.jpeg "Fig. 35")
Fig. 35
After enamel extraction, a full-thickness mucoperiosteal flap was once created to offer ok get entry to to the surgical web page (Figs. 34 & 35). A buccal and lingual vertical liberating incision was once made to verify tension-free closure. The incision prolonged past the world of deliberate bone relief to facilitate right kind flap mobilisation and make sure excellent protection for the therapeutic procedure.
The second one surgical information was once positioned, and bone and bone relief was once carried out (Figs. 36–39). The 3rd surgical information was once then positioned for preparation of the implant mattress, and the Straumann Surgical Cassette was once used in step with the pilot drilling protocol (Figs. 40–43). The implants have been positioned with the help of the handpiece in a clockwise path at a velocity of 15 rpm and to a torque of 35 N cm (Fig. 44). Screw-retained abutments (Straumann) have been positioned in step with the virtual making plans (Figs. 45 & 46).
Because the implant loading protocol was once fast loading, after placement of the transient copings, a recovery copy was once tailored. Within the laboratory, the analogues have been positioned (Figs. 47 & 48). Variobase abutments (Straumann) have been put on best of the screw-retained abutments to verify balance and improve of the provisional recovery (Figs. 49 & 50).
After treating the mandibular arch, we proceeded with the maxillary arch. The flap design concerned a flapless method for the maxillary arch. All tooth within the maxillary arch have been extracted, excluding for the molars (Figs. 51 & 52). The provisional recovery was once seated and tailored to the mouth after the enamel extractions (Figs. 53–55). The implant websites have been ready following the producer’s directions, the implants have been therefore inserted and screw-retained abutments (Straumann) have been positioned (Figs. 56 & 57). Guided bone regeneration with Straumann XenoGraft and a resorbable membrane (Straumann) have been then carried out (Figs. 58–60).
Brief abutments have been then put on best of the screw-retained abutments to verify balance and improve of the provisional recovery (Figs. 61 & 62). The provisional recovery was once moderately tightened to between 15 N cm and 35 N cm at the transient abutments immediately within the mouth to verify an exact are compatible, optimum convenience and right kind capability for the affected person (Figs. 63–66).
At the day that the sutures have been got rid of, superb therapeutic was once noticed. The follow-up radiograph additionally showed the right kind positioning of the implants (Figs. 67 & 68).
Prosthetic process
After a therapeutic duration of 5 months and a success osseointegration, the method for the definitive restorations was once initiated. The selected subject material was once milled monolithic zirconia, and Variobase ultimate abutments was once used, positioned at the screw-retained abutments to verify superb balance and retention of the definitive restorations (Figs. 69–75).
The cushy tissue was once in excellent situation, and the definitive restorations have been positioned (Figs. 76 & 77). After hanging the definitive restorations, oral hygiene directions got to verify right kind care and save you headaches. Moreover, the occlusion was once moderately checked and altered as wanted (Figs. 78–83).
A follow-up was once carried out six months after surgical treatment. The radiographic exam performed at the moment showed the a success integration and balance of the implants (Fig. 84).
Remedy results
Excellent effects have been completed relating to each arduous and cushy tissue, in addition to aesthetics. The affected person shared the next testimonial: “I couldn’t be happier with my new smile! The method was once so exact and seamless, and I felt concerned each step of the way in which. The virtual making plans made it transparent what to anticipate, and the effects are past what I imagined—pure, stunning and completely suited for me. Consuming and smiling really feel easy once more. It’s in point of fact life-changing!”
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