GuidedSMILE Case Study – Full Arch Rehabilitation

A male patient presented with a long history of neglected dentition. Having avoided dental treatment for many years due to dental anxiety, he experienced progressive deterioration of both function and confidence. The failing dentition impacted his ability to eat comfortably and contributed to significant aesthetic concerns.

Treatment alternatives

The treatment options discussed with the patient included:

• No treatment
• Removable dentures
• Implant retained overdentures
• Bar retained implant dentures
• Full arch fixed bridgework

After careful consideration, the patient chose a fixed solution, seeking a stable, aesthetic, and long term outcome to restore both function and confidence.

Digital planning and workflow

Quoris3D planned the patient's case digitally using RealGUIDE, as part of the CHROME GuidedSMILE workflow. The chosen treatment plan involved a full arch rehabilitation with a lower FP3 and an upper FP1 restoration.

The planning began with the precise alignment of CBCT data, intraoral scans, and a diagnostic wax up. This integration established a clear restorative reference to guide prosthetically driven implant placement.

Upper FP1 planning

For the upper arch, the goal was to deliver a natural, gingiva level FP1 restoration. Implants were planned within the prosthetic envelope to support the desired emergence profile and screw access. Particular attention was given to angulation, bone support, and the avoidance of anatomical structures such as the sinus and nasal floor, ensuring both surgical feasibility and aesthetic harmony.

Lower FP3 planning

For the lower FP3 restoration, implant positions were strategically planned to achieve optimal anteroposterior spread and implant distribution. Restorative space and vertical dimension were carefully evaluated to accommodate the full contour zirconia prosthesis, ensuring sufficient restorative thickness and soft tissue support.

Precision through digital technology

Implant positioning was refined to balance biomechanical stability with restorative efficiency. RealGUIDE’s advanced visualisation tools allowed cross referencing of the prosthetic plan with the underlying bone anatomy, confirming that each position was both surgically and prosthetically ideal.

Guided surgery and conversion

Integration with the CHROME GuidedSMILE protocol enabled a seamless transition from digital planning to guided surgery. This ensured highly accurate implant placement and efficient chairside conversion, providing Dr Mylchreest with a predictable and streamlined workflow.

Outcome

GuidedSMILE’s combined digital planning and surgical protocol resulted in a highly accurate and efficient full dual arch rehabilitation. All implants were placed with precision in accordance with the digital plan, ensuring ideal angulation, depth, and parallelism. The immediate conversion phase was smooth, enabling the patient to leave with a fixed provisional restoration that provided both stability and function from day one.

Postoperatively, healing progressed uneventfully, and the patient quickly adapted to the new prosthesis, reporting a significant improvement in comfort and masticatory efficiency. The final restorations delivered a balanced occlusion, natural aesthetics, and excellent phonetics. The combination of the upper FP1 and lower FP3 restorations achieved a harmonious smile line and soft tissue profile, enhancing both facial support and appearance.

This case demonstrates how a fully digital, prosthetically driven approach delivered by the CHROME GuidedSMILE workflow can streamline the surgical and restorative process, minimise intraoperative adjustments, and deliver highly predictable outcomes. Beyond the clinical success, the transformation had a profound impact on the patient’s confidence and overall quality of life, reinforcing the value of guided full arch rehabilitation in modern implant dentistry.

Dr. Seb Mylchreest’s review

“ Meticulous planning is absolutely central to achieving a predictable and high quality outcome in full arch rehabilitation. By investing time in aligning the diagnostic data and digitally mapping the ideal restorative positions, we’re able to work from a prosthetically driven plan rather than adapting to the bone on the day. The RealGUIDE and CHROME GuidedSMILE workflow gives us the accuracy and confidence to translate that plan seamlessly into surgery. In this patient's case, that level of precision was key to delivering a stable, functional, and aesthetic result that met both clinical and patient expectations.