J Biol Regul Homeost Agents. 2021 Jul-Aug;35(4 Suppl. 1):71-85. doi: 10.23812/21-4supp1-7.

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Minimally invasive digital implant-prosthetic procedure in “all on 4” rehabilitation in patients with special needs: a three-year follow-up

Merlone A1, Tetè G1, Cantile N1, Manacorda M1, Cattoni F1.

Author information

1  Dental School, Vita-Salute University and Department of Dentistry, IRCCS San Raffaele Hospital, Milan, Italy.


The present study describes an innovative procedure for resolving implant-prosthetic cases in patients with edentulous special needs. In 2017 a 56-year-old female patient came to the Department of Dentistry of Vita-Salute San Raffaele Hospital, Milan, Italy, requiring implant-prosthetic rehabilitation of the dental arches given the difficulty in wearing removable prostheses. The first level radiological examinations were evaluated, two technical photographs were taken with specific reference, the 2D Digital Smile Design (Smile Design) was then carried out, the provisional prosthesis was performed and the CBCT requested with repere and provisional prostheses to realize the computerized implant project and an atraumatic flapless guided surgery. Professional oral hygiene sessions were performed quarterly, and the 3-year follow-up revealed no complications affecting the prosthetic or implant component. We can therefore conclude that the proposed method, exploiting digital technologies and flows and minimally invasive flapless surgical methods, can be considered elective in the treatment of patients with special needs.


all on 4, implant prosthetic rehabilitation, prosthetic rehabilitation, tilted implant

Publication type

  • Clinical Study

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