I. Basic Information

Name: Ms. Jin

Gender: Female

Age: 55 years

Chief Complaint: Tooth loss for over ten years; requesting treatment.

Past Medical History: None reported.

Present Dental History: Tooth loss for more than a decade; wearing a removable partial denture with discomfort during eating; presented to our clinic for treatment.

II. Clinical Examination

Specialised Examination:

Maxillary and mandibular partial edentulism; remaining teeth exhibited Grade III mobility, root exposure, gingival erythema and swelling, percussion pain, and poor oral hygiene.

No tenderness on palpation in the bilateral temporomandibular joint areas.

Auxiliary Examination: Radiographic examination was performed.

III. Diagnosis and Treatment Plan

Diagnosis: End‑stage dentition.

Treatment Plan: Implant‑supported restoration with a removable prosthesis.

IV. Treatment Procedure

Pre‑operative Preparation (November 2025): The patient was informed of the condition, treatment plan, costs, and prognosis, and provided informed consent. The patient opted for implant restoration. Pre‑operatively, routine oral anti‑inflammatory, anti‑oedema, and analgesic medications were administered, and chlorhexidine mouthwash was used for 3–5 minutes, twice.

Surgical Procedure:

Routine disinfection and nerve‑block anaesthesia with compound articaine hydrochloride were performed. Mobile teeth and residual roots were extracted. A full‑thickness flap was reflected, granulation tissue was removed, and osteotomies were prepared for implant placement.

Implants placed:

At site 22: Hanzu® implant 4.0×13 mm, torque 35 N·cm;

At site 24: Hanzu® implant 3.75×11.5 mm, torque 35 N·cm;

At site 16: Hanzu® implant 4.5×8.5 mm, torque 35 N·cm;

At site 26: Hanzu® implant 5.0×7 mm, torque 35 N·cm.

Bone graft material was placed in the bone defects, and multifunctional abutments were connected. The wound was closed with tight sutures.

Immediate Post‑operative Radiograph: Confirmed satisfactory implant positioning. An immediate loading provisional prosthesis was fabricated and delivered.

Post‑operative Care and Instructions:

Routine anti‑inflammatory and anti‑oedema oral medications were prescribed; analgesics were given as needed.

Chlorhexidine mouthwash 10 ml per rinse, three times daily.

Oral hygiene instructions were provided.

Patient Advice:

Consume lukewarm soft foods after 2 hours.

Do not brush or rinse for 24 hours; swallow saliva if possible.

Maintain meticulous oral hygiene in the implant areas and follow implant‑specific post‑operative instructions.

Sutures to be removed in 7–10 days.

Follow‑up: Sutures were removed approximately 1–2 weeks later according to the patient's condition.

V. Clinician Profile

Name: Li Shiling

Affiliation/Title: Chief Implant Surgeon, June Smile Dental Group

Honours and Achievements:

Master of Dental Implantology, University of California, San Francisco (UCSF) School of Dentistry;

Member of the Chinese Stomatological Association and its Oral Implantology Committee;

Member of the American Dental Association (ADA);

Certified Instructor for the Zhenweimei Implant System (Germany).