Rehabilitation of a patient with partial mandibular adentia using immediate loading and introoral stabilization of implants: a clinical case

The presented clinical case is devoted to the problem of rehabilitation of patients with postextractional atrophy of the mandible, in which standard protocols of implantation treatment are of limited use due to unfavorable qualitative characteristics of bone tissue and features of the anatomy of the alveolar ridge. Despite the accumulated clinical experience in the field of simultaneous implantation and immediate loading, the issue of their use in conditions of reduced bone density and the need for rapid functional stabilization without extended laboratory steps remains insufficiently addressed. This circumstance served as the basis for the publication of this observation, demonstrating an alternative clinical approach to solving this problem and its practical feasibility.

The clinical case describes a patient with partial mandibular adentia and a long history of tooth loss. The clinical situation was complicated by the limited possibilities of achieving implant stability with traditional single-stage implantation schemes. A protocol for the installation of implants with an immediate functional load was chosen, including the manufacture of a temporary orthopedic structure and introoral welding of a metal frame for rigid integration of the implants. The orthopedic design was adapted directly into the oral cavity with subsequent relocation. In the early postoperative period, satisfactory primary stabilization was achieved, chewing function was restored and an acceptable functional and aesthetic result was achieved without signs of complications.

The conclusion of this clinical observation emphasizes that under unfavorable anatomical and clinical conditions, the key success factor may be not so much the absolute volume of bone as the possibility of early mechanical stabilization of implants and control of micro-mobility. The use of introoral welding makes it possible to shorten the duration of treatment and minimize the number of stages, however, it requires high accuracy and strict selection of patients. The results obtained should not be directly extrapolated to broad groups of patients, but they demonstrate the potential of this approach as one of the treatment options in complex clinical situations.