Immediate implant supported prosthodontic treatment of the edentulous jaw with additional implant stabilization.

Aim: To increase the reliability, quality, and incidence of favorable outcomes during mandibular direct implant prosthetic treatment using the Trefoil system.

Materials and methods: This study included 48 patients (age: 63-85 years). Visualization assessment (CBCT) was performed using Planmeca Promax 3D Mid, and bone density was examined using dual energy X-ray absorptiometry (densitometry, DXA). The final sample consisted of 16 patients deemed suitable for immediate implant placement and loading of permanent prosthesis on the mandible. The distal implants were stabilized using a customized structure made of Titanium Ti6-Al4-V using DMLM 3D printing technology with Concept Laser machines. Modeling of the contours of the jawbone at the planned surgical site was carried out using cone-beam computed tomography and the Mimics Medical 21 software (Materialize, Germany) for each patient. A total of 32 such devices were created.

Results: Of these, 18 were used as the initial implant stability was less than 35 N/cm of torque in a few cases only. The implant survival rate was 100% after 18 months. This method of mandibular implant prosthetic treatment using a customized device for implant stabilization has been patented.

Conclusion: Splinting of the compact walls of the mandible using a customized structure optimized stabilization of the Trefoil prosthetic construction on porous bone (type IV) following extraction of teeth and placement of implants. Clinical testing of the reported method confirmed its viability for dental rehabilitation of elderly patients and proved its ability to provide a good quality of life by creating stable implant prostheses with high functionality.