20 April 2026

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Case report: the role of digital dentistry in managing clinical and social complexities in implantology

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Objective

To report a fully digital and guided immediate-load All-on-4 protocol conducted in Brazil on a 59-year-old male patient with an edentulous maxilla and a history of oropharyngeal cancer surgery, chemotherapy, and 60 head-and-neck radiotherapy sessions. After being released by the medical team, the digital workflow was chosen, with focus on surgical accuracy, clinical efficiency, and patient-centered outcomes in a context of financial limitations and logistical challenges, requiring an optimized digital solution.

Methods

Well-adapted provisional upper partial acrylic and lower complete dentures were fabricated, with gutta-percha markers placed for tomographic acquisition and bite registration in silicone. DICOM files were integrated into surgical planning software to design three guides: one for extractions, one for osteoplasty, and a third magnetically coupled guide for implant placement. Four cone morse implants were placed under local anesthesia: two straight (Ø 3.5 × 11 mm) and two 30° angled (Ø 4.3 × 13 mm), followed by immediate loading using the adapted upper prosthesis.

Results

All implants achieved primary stability (>35 Ncm) and were immediately loaded without intraoperative or postoperative complications. Clinical time and number of visits were significantly reduced compared to conventional protocols. At the 6-month follow-up, peri-implant tissues remained healthy, with full recovery of function, aesthetics, and emotional well-being. The patient reported high satisfaction, improved quality of life, and social reintegration.

Conclusions

This case demonstrated how digital dentistry can offer efficient and humanized solutions for high-risk oncology patients, especially in scenarios with limited access, time, and resources. Technology allowed for minimized surgical and logistical risks, promoting inclusion, predictability, and quality of life.

Authors: Matheus Pinós, Vinicius Fabris, Paulo Herpich, Eduardo Mukai

source: https://www.sciencedirect.com/