Reabilitação total sobre implantes utilizando sistema de cirurgia guiada KEA-TECH: relato de caso clínico.

Abstract

This course completion work aimed to describe a new technique of guided surgery that eliminates the need to use CAD-CAM technology for making surgical guides. In this technique the total prosthesis is the tomographic guide, surgical guide and the prosthetic capture guide, with the advantage of being stabilized in mini implants previously installed in the chin region, which keep the position of the multifunctional guide constant throughout the process. In this context, the female patient M.C.C.F, 47 years old, with a bimaxylated total toothless, was rehabilitated with upper removable total prosthesis (PTR) and implant-supported fixed lower total prosthesis using immediate loading and guided surgery. To make the tomographic guide, a lower plasticization of the lower PTR was first performed in order to obtain a precise matrix, to which a tomographic plate from the KEA-TECH system was adhered using self-curing acrylic resin. The set was perfectly adapted on the occlusal surface of the PTR, which previously received the application of radiopaque solution on its occlusal surface and on the internal surface corresponding to the ridge crest. The set was called KEA tomographic guide and was stabilized by two self-extracting mini-implants installed in the symphysis region during tomographic scanning. In the KEA-Tech planning software, after checking the adequate bone volume in the tomographic images, four implants with a Morse taper connection (3.75 x 13 mm) were planned in the regions of teeth 33, 43, 35 and 45. The spatial coordinates corresponding to the position of each implant were generated virtually and transferred to the KEA-Tech tube positioning device (DPT). The DPT allows to transfer the coordinates of the position of the implants planned in the KEA guide software to the total prosthesis, transforming it into a restrictive surgical guide by installing the guide tubes in the patient's total prosthesis in the planned three-dimensional position. The surgical guide was stabilized by the mini-implants, allowing the installation of the implants with greater precision in the planned regions. Then, mini-abutments were installed and the surgical guide was captured, transforming it into an immediate implant-supported provisional prosthesis. The accuracy of the technique was verified by performing postoperative tomography, comparing the position of the planned and installed implants.