Fig. 3

Prosthetically driven 3D implant planning. a In a guided surgery software (RealGuide®, 3Diemme, Como, Italy) the. STL file with the ideal teeth morphology (model of the maxilla with included wax-up) was imported and superimposed on the bone anatomy, obtained from the CBCT. Ten immediate post-extraction implants (#16, #14, #13, #12, #11, #21, #22, #23, #24, #26) were planned in the cross sections of the CBCT (placement of #16 and #26 required maxillary sinus augmentation). The implant position, inclination and depth were carefully planned, trying to engage the fixtures as much as possible into the bone, to increase primary implant stability in the fresh extraction sockets, and taking into account the emergence profile and the overlying future prosthesis, so that implants were placed in a prosthetically driven matter. The final prosthetic plan foresaw rehabilitation with single crowns in the frontal area (from #14 to #24) and rehabilitation with partial fixed prosthesis for the posterior sectors (from #15 to #17, and from #25 to #27, respectively). b A similar procedure was performed in the mandible, with the superimposition of the. STL file with the ideal teeth morphology on the bone, and therefore the implant planning. Six implants were originally planned (#47, #46, #41, #31, #35, #37) in the cross sections of the CBCT. Once again, the implant position, inclination and depth were carefully planned, trying to engage the fixtures as much as possible into the bone, to increase primary implant stability, and taking into account the emergence profile and the overlying future prosthesis, so that implants were placed in a prosthetically driven position. c, d Visualization of the implant emergence profiles in relation to the ideal position of the teeth and the prosthetic plan, in the maxilla and mandible. The prosthetic axes of the posterior implants emerged in the masticatory center of each tooth, in the anterior individual zirconia abutments cemented on titanium bases were chosen. On the upper jaw ten implants were planned, on the lower jaw six