Colocación de Implante Dental Guiado en Maxilar Posterior con Proximidad al Seno Maxilar mediante Técnica Mínimamente Invasiva: Reporte de Caso Clínico

Vollständiger Abstract

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Implant rehabilitation in the posterior maxilla represents a clinical challenge due to limited bone availability and the proximity of the maxillary sinus. The aim of this report was to describe the clinical and surgical management of a guided dental implant placed in close proximity to the maxillary sinus using the OneGuide® system, a flapless tissue punch technique, and immediate healing abutment placement. A case of a 70-year-old female patient, medically stable (ASA II), presenting with the absence of tooth 25 (FDI notation) is reported. The diagnostic evaluation included clinical and periodontal examination, as well as cone-beam computed tomography (CBCT). Treatment planning was performed through a digital workflow that included a diagnostic wax-up and prosthetically driven guided surgery. The surgical procedure consisted of a flapless tissue punch approach, guided osteotomy preparation, and placement of a Hiossen® ETIV implant (4.0 × 8.5 mm) in proximity to the maxillary sinus. Primary stability of 30 Ncm was achieved, allowing immediate placement of a healing abutment. Clinical follow-up revealed favorable peri-implant soft tissue healing, absence of postoperative complications, and proper three-dimensional implant positioning confirmed radiographically. The combination of guided surgery and minimally invasive techniques proved to be a safe, precise, and predictable alternative for implant placement in anatomically challenging areas adjacent to the maxillary sinus.