A Novel Approach for Immediate Implant-based Oral Rehabilitation in a Sjögren's Syndrome Patient Using Virtual Surgical and Prosthetic Planning.

Sjogren's syndrome (SS) patients experience difficulties in wearing conventional dentures. After removal of all teeth the oral rehabilitation is challenging and time consuming using conventional treatment protocols. Although implant-retained overdentures are beneficial for this specific patient group, the average total oral rehabilitation time (TORT) usually takes at least six months and needs to be reduced to increase patients' quality of life (QoL). In this paper we report on a new treatment concept for immediate implant-based oral rehabilitation in a 77-year-old partial edentulous SS patient. Because of persistent pain, discomfort and retention problems with the conventional prosthetic devices, full clearance of the remaining mandibular dentition and immediate oral rehabilitation with an implant-retained overdenture were suggested. The treatment protocol included virtual surgical planning (VSP), combining a guided bone reduction of the mandibular alveolar process, immediate dental implant placement and restoration using a prefabricated bar and placement of the overdenture. This method demands the use of ionizing 3D imaging optionally combined with an optical dental scan or a conventional impression. Furthermore, one needs to gain experience using VSP software. This novel treatment concept for immediate implant-based oral rehabilitation using VSP proved to be feasible and safe in a SS patient, resulting in a significantly reduced TORT and improved QoL. Further research is needed to what extent this treatment concept could be beneficial to other patient groups, such as head and neck cancer patients.