Digitally guided alveolar ridge osteoplasty and immediate rehabilitation with a removable partial denture: Technique report and literature review

This technical report presents a digital protocol for planning and fabricating a 3D-printed surgical guide for maxillary alveolar ridge reduction, combined with the immediate placement of a removable partial denture. A clinical case of an 80-year-old female patient requiring maxillary prosthetic rehabilitation was used to demonstrate the protocol. Digital impressions, lip scans, and cone-beam computed tomography (CBCT) were used for virtual planning. Two surgical guides were designed based on digitally modified 3D models derived from virtual surgical simulations of vertical and horizontal bone reduction. The provisional removable partial denture was subsequently designed based on the final virtual postoperative anatomy, which incorporated both simulated bone reductions. All surgical and prosthetic devices were produced via 3D printing using biocompatible resins. The surgical guides enabled precise bone reduction aligned with the planned prosthetic design. The immediate denture showed satisfactory adaptation, retention, and stability, with no need for relining or additional adjustments. This protocol reduced chair time and enabled faster prosthetic rehabilitation. The proposed technique demonstrated clinical feasibility and accuracy for guided pre-prosthetic surgeries in cases with anatomical limitations. It allows the immediate placement of mucosa-supported prostheses after ridge regularization, optimizing the clinical workflow and patient outcomes. This protocol expands the use of digital workflows and surgical guides beyond implant dentistry, offering a predictable solution for removable prostheses in challenging clinical situations. It addresses common challenges in edentulous maxillary cases, such as reduced interarch space and irregular ridge morphology, by integrating CAD/CAM planning, soft-tissue visualization, and prosthesis-guided bone contouring.