Perio Health Professionals

A digital guided surgery system (DSD Clic-Guide, Digital Smile Design) is a digital rehabilitation planning system recommended in the rehabilitation of fully edentulous jaws, which orients implant placement procedures, immediate provisional loading, and final prosthesis based on an ideal facially generated three-dimensional design. This system increases the level of predictability of procedures in complex clinical cases and consists of a sequence of surgical guides used during procedures that may include teeth extractions, osteotomies, implant placements, and immediate prosthesis installation. This case report aims to present the complete digital workflow of a dual full-arch oral rehabilitation using a guided system, from initial planning through final restoration, with a 2-year post-restoration follow-up. The patient treated required total oral rehabilitation in both arches. 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 3D printed temporary prosthesis for immediate loading, bone reduction, and osteotomy. At the 2-year follow-up appointment post-restoration, the prosthesis and implants remained stable. The implants appeared healthy, with no signs of bone loss. The patient was extremely satisfied with the treatment, esthetics, and function. It can be concluded that the digital guided surgery system enabled the osteotomy, implants placement, and installation of an immediate loading prosthesis in totally edentulous patients, allowing for the delivery of temporary and ultimately final restorations with a high level of predictability. Careful digital planning in stages makes full-arch rehabilitation more predictable and reliable. Even patients with severe periodontal disease can be treated successfully using integrated digital workflows. Collaboration among different specialists, supported by digital technology, improves treatment efficiency and long-term results. A patient's loss of multiple teeth in both jaws and advanced bone loss result in a challenging condition that requires complex treatment to restore a person's ability to eat, speak, and smile. In this case, we describe how digital technology was used to plan and complete a full-mouth rehabilitation for a patient with severe dental problems. Computed-based scans and surgical guides were used in planning the position and accurate placement of implants. A sequence of guides was created to ensure each step of the surgery was carried out in a controlled and predictable way from removing teeth, to placing implants, and finally to attaching temporary prostheses. The patient received temporary prostheses on the same day as the surgery, and later permanent prostheses were added. At the 2-year follow-up, the implants and prostheses were stable, healthy, and functioning well. The patient reported being very satisfied with the outcome. This case shows how digital workflow and teamwork can make even the most challenging dental cases more predictable, efficient, and successful, offering important benefits for patients with advanced oral health problems.

ABSTRACT Effective nurse-to-family communication is critical in intensive care units (ICUs), where high acuity and emotional complexity demand rapid trust-building and clear information exchange. This qualitative study explored ICU nurse leaders’ perceptions of the COMFORT communication intervention, a structured, theory-driven model designed to enhance relationship-centered communication with families. Seventeen nurse leaders from a statewide health system participated in virtual focus groups assessing the COMFORT model’s seven components of COMFORT: Connect, Options, Making Meaning, Family Caregiver, Openings, Relating, and Team for practicability, appeal, and relevance within ICU workflows. Directed content analysis revealed strong support for the Connect, Family Caregivers, and Openings components, emphasizing their foundational role in establishing rapport and supporting emotionally charged conversations. Components such as Relating and Options were perceived as less feasible due to time constraints and staff discomfort with sensitive discussions. Leaders recommended a phased, scaffolded implementation strategy using mobile technology to promote accessibility and just-in-time learning. Emphasis was placed on integrating training into onboarding and leveraging unit workflows to sustain communication practice over time. Findings suggest that nurse leaders view the COMFORT model as a practical and scalable framework to strengthen nurse-to-family communication. The study highlights the importance of tailoring communication interventions to clinical realities and leveraging leadership support to foster trust and engagement in critical care contexts.