Elderly patients often present with multiple co-morbidities and reduced mobility, making frequent dental visits challenging. Many have insufficient residual bone for fixed implant prostheses, while limited manual dexterity or cognitive decline may compromise oral hygiene. Financial limitations can also preclude multiple implant placements. In such cases, an implant-supported overdenture offers an optimal balance between function, aesthetics, and cost. Digital technologies now allow streamlined treatment with fewer appointments, greater accuracy, and improved comfort. This proof-of-concept protocol integrates a full digital workflow for extractions and immediate delivery of a digitally designed, 3D-printed removable denture, followed by immediate implant placement and fabrication of the definitive overdenture with minimal clinical sessions.
Methods: The protocol was applied to maxillary and mandibular edentulous cases. Preoperative data included intraoral scanning, CBCT, facial scanning, and virtual patient integration. Digital planning in Exocad DentalCAD software involved virtual articulator use for occlusal plane modeling, digital smile design, extraction simulation, implant positioning, and denture design. Removable dentures were 3D-printed in biocompatible resin and delivered immediately after extractions. Where indicated, implants (four in the maxilla, two in the mandible) were placed in the same session using sleeveless guided surgery planned in R2Gate software, and the dentures were adapted as interim prostheses. Definitive overdentures were fabricated conventionally in fewer appointments. Patient-reported outcomes were measured on a Visual Analog Scale (VAS).
Results: The workflow enabled accurate pre-surgical planning, immediate prosthesis delivery, and efficient transition to the final overdenture. In both arches, immediate dentures provided satisfactory aesthetics and function during healing. Patient satisfaction was high, especially due to reduced treatment time and minimal visits.
Conclusions: This protocol is a feasible, predictable, and time-efficient approach for elderly patients, reducing discomfort and enhancing treatment acceptance. Validation in larger cohorts is recommended.
