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One of the limitations of using guided surgery for full arch rehabilitation is related to the cases where it is necessary to perform osteotomy prior to the placement of the implant. The Digital Smile Design ClicGuide (DSD ClicGuide) is a digital rehabilitation planning system recommended in the rehabilitation of fully edentulous jaws, which orients implant placement procedures and immediate provisional loading based on an ideal three-dimensional design. This system consists of a sequence of surgical guides used during the clinical procedures that may include teeth extractions, osteotomies, implant placements, and immediate prothesis installation, increasing the level of predictability of rehabilitation procedures in these complex clinical cases. The aim of this case series report is to describe the oral rehabilitation of three patients treated according to the DSD ClicGuide technique, who received a total of twenty dental implants. All the patients treated required total oral rehabilitation in at least one of the arches and required osteotomies in order to regularize the alveolar ridge before the placement of the implant. Once the rehabilitation parameters were defined and the treatment plan was approved, the following guides were printed and used in sequence: a base guide that was used as a reference for the osteotomy procedure; a guide for installing the implants; and a guide with the printed temporary prosthesis for immediate loading. It can be conclude that the DSD ClicGuide system enabled the osteotomy, implants placement, and installation of an immediate loading prosthesis in totally edentulous patients, with a high level of predictability.

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The DSD clicGuide system: a new concept for full-arch implant placement and immediate loading rehabilitation using the digital workflow: a clinical report of three cases