Computer-guided implant placement for rehabilitation of the edentulous maxilla with two impacted canines: an approach without extraction of the impacted teeth.

The aim of this report was to suggest an alternative approach to avoid impacted canine extraction by utilizing computer-guided implant placement for providing an implant adjacent to the impacted canine without contact to the impacted tooth. In cases when the adjacent area is available for implant placement, a computerized three-dimensional (3D) planning system can be used to place implants in a way that avoids the impacted canine. Tilted implants could be used to achieve the proper support for implant-supported fixed dentures without damaging the impacted teeth. Following careful 3D planning, a computer-derived surgical stent is used to guide the surgical placement of the implants in the proper place. Since the position of the implants is known prior to the surgical procedure, a prefabricated provisional restoration is delivered immediately at the end of the surgery. Following a waiting period of 6 months, the implant-supported definitive restoration is fabricated using the same technique and delivered to the patient, making sure that proper maintenance and oral home care hygiene are feasible. This suggested treatment modality, when suitable, could provide a relatively short treatment time, a less invasive procedure, and fewer potential complications compared to the extraction of an impacted canine, massive bone grafting, and implant placement. Also, it might be assumed that the use of the native bone, as suggested here, rather than an augmented bone could lead to better long-term results.