What is a GuidedSMILE Revision case, and which patients are candidates?
A revision case always starts from the same place: the patient already has implants and an existing fixed or removable prosthesis. Something has since changed. There was an event, there has been wear and tear, or the original plan did not account for something. The patient now needs more implants, more componentry, a new prosthesis, or a complete retreatment of the arch.
GuidedSMILE Revisions applies the CHROME stackable guided surgery protocol to these patients so that new implants, fixation, and bone reduction are all planned from the teeth down before the patient is ever in the chair. It is a guided surgery protocol, not a freehand one, and it supports both digital and analog record workflows.
Clinical triggers that signal a revision
| Trigger | What you see clinically | Typical revision response |
|---|---|---|
| Implant failure | One or more implants lost or failing, often creating a long unsupported span | Replace the failed implant and add implants for balance |
| Bone loss | Progressive loss around existing implants, compromised support | Bone reduction, additional implants, improved AP spread |
| Poor original placement | Implants too small, poorly positioned, asymmetric, insufficient AP spread | Add strategically placed implants, including pterygoids |
| Prosthetic wear or failure | Fractured, worn, or repeatedly repaired acrylic, visible field repairs | New prosthesis, often with more implant support |
| Insufficient prosthetic space | Transition line display, limited vertical dimension | Bone reduction, opening the bite, or both |
| Change of prosthesis type | Patient wants to move from removable to fixed | Full candidacy workup (see FAQ 2) |
| Parafunction | Bruxism, clenching, accelerated wear through multiple prostheses | Deliberate overengineering with additional implants |
Why revision volume is growing
Full arch dentistry has reached a scale where retreatment is now a predictable part of practice rather than an exception.
| Metric | Figure | Context |
|---|---|---|
| Full arch cases completed in the US in a recent calendar year | Approximately 100,000 | Fixed and removable combined |
| Basis for that estimate | Multi-unit abutment purchases | Likely an undercount, since some systems do not use multi-unit abutments |
| Additional volume not captured | Dental tourism cases | Adds further to the true total |
| Annual growth rate | Roughly 7 to 9 percent | Driven in part by the spread of dedicated full arch centers |
Expected service life of existing prostheses
| Prosthesis type | Reported service life | Notes |
|---|---|---|
| Traditional hybrid with titanium bar | 12 to 15 years | The long-standing figure, and consistent with field experience absent heavy abuse |
| Full arch monolithic zirconia | Not yet established | The industry has roughly 10 years of broad clinical use. The material is expected to outlast acrylic hybrids, but long-term behavior of the underlying implants and bone is still being studied |
Every full arch practice should have a protocol for accepting these patients. They are not straightforward cases, and they will walk in the door.
Learn more about the foundation system on the CHROME GuidedSMILE page, or see how Revisions fits alongside the rest of the GuidedSMILE family of products.
Resources
Contact Information
For immediate chairside support or troubleshooting assistance, contact ROE Dental Laboratory:
- Phone: (216) 663-2233
- Email: info@roedentallab.com