Restoring Confidence with GuidedSMILE: A Full Arch Rehabilitation by Dr Mide Ojo

A male patient presented with a long standing history of poor oral health and advanced periodontal disease. Having avoided dental care for many years due to anxiety, he experienced progressive deterioration of his dentition. The loss of function and aesthetics had begun to impact his confidence and overall quality of life, motivating him to seek a long term solution.

Clinical examination revealed extensive periodontal involvement, with most teeth deemed unrestorable. The patient expressed a strong desire for a fixed and stable solution that would restore both appearance and function, enabling him to eat and smile with confidence once again.

Digital planning and workflow

The case was digitally planned by Quoris3D using the CHROME GuidedSMILE workflow. This fully guided approach ensured precision at every stage, from diagnosis through to delivery. Comprehensive diagnostic records were collected, including a CBCT scan for bone quality and anatomical assessment, intraoral scans of both arches to record soft tissues and occlusion, and a full photographic series to support aesthetic evaluation and smile design.

All files were accurately aligned within RealGUIDE, creating a precise three dimensional virtual representation of the patient’s anatomy. This virtual model formed the foundation for prosthetically driven planning, ensuring that implant positions conformed to the optimal restorative envelope. A digital wax up established the ideal tooth positions, occlusal plane, and vertical dimension. Each implant was then virtually positioned to balance bone availability, prosthetic emergence, and functional biomechanics, whilst maintaining safe distances from critical structures such as the mandibular nerve and maxillary sinuses.

CHROME GuidedSMILE guide design

Once the digital plan was finalised, the data was transferred to the GuidedSMILE design team for guide fabrication. The system employs stackable components, each serving a specific purpose within the guided sequence to deliver surgical accuracy and efficiency:

• Fixation base for stabilisation
• Pin guide for verification
• Osteotomy guide for precise site preparation
• Bone reduction guide to establish restorative space
• Prosthetic seating guide
• RAPID Appliance for restorative transfer

This multi step workflow minimised surgical variability, allowed verification of each stage against the plan, and ensured predictable execution from start to finish.

Guided surgery and immediate conversion

Surgery was completed over two stages following the CHROME GuidedSMILE protocol. The first arch was performed under the mentorship of Dr. Alan Wilson, ensuring seamless integration of the digital plan into surgical execution. The guided workflow allowed bone reduction, implant placement, and immediate prosthetic conversion to be carried out with exceptional precision.

Two weeks later, the second arch was completed by Dr. Ojo using the same guided process. Experience gained from the initial stage, combined with the accuracy of the digital plan, contributed to an efficient, predictable procedure. Implant stability was excellent, and both provisional restorations were delivered chairside using the immediate conversion technique.

The provisional prostheses were carefully designed to replicate the planned final aesthetics, allowing the patient to leave with a fixed, functional, natural looking smile on the same day. Post operative recovery was uneventful, with the patient reporting minimal discomfort and rapid adaptation.

Outcome

After a healing period of approximately five to six months, the patient returned for transition to the definitive restorations. The RAPID Appliance was utilised to verify occlusion, vertical dimension, and aesthetic parameters, ensuring a precise transfer to the final prostheses.

The definitive restorations demonstrated an exceptional fit and stable occlusion, with a natural appearance complementing the patient’s facial profile. Functionally, the patient reported significantly improved chewing efficiency and comfort. Aesthetically, the transformation was outstanding, enhancing both smile and overall facial balance.

The patient expressed complete satisfaction with the final outcome, highlighting comfort, natural appearance, and the life changing impact of the treatment.

Dr. Olumide Ojo’s review and reflections

“ The GuidedSMILE workflow is a seamless process—every stage has been thought through. From the initial records to the fitting of the CHROME guide, bone reduction, and final prosthetics, every component was made to exact dimensions. It takes away the stress of freehand surgery and ensures that every step aligns perfectly with the digital plan. I feel much more confident offering this treatment, knowing that accuracy and predictability are built into the process.

Challenges during the initial procedure related to the extent of periodontal infection and maintaining anaesthesia. These were effectively managed through improved pain control protocols and learnings from the first stage. Subsequent procedures were smoother and highly predictable, reinforcing the value of guided precision and thorough digital planning.

Conclusion

This case demonstrates how careful digital planning and a structured guided workflow can make complex full arch treatment more straightforward and predictable. The combination of accurate records, coordinated digital design, and the CHROME GuidedSMILE system allowed each stage to be completed with confidence and control.

By following a clear, step by step process, Dr. Ojo delivered a stable, functional result that met both clinical and aesthetic goals. The patient’s recovery and satisfaction reflect the value of this approach, showing how digital precision supports reliable, long term outcomes for both patient and clinician.