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In this case report, we demonstrate how the correct positioning of implants, associated with optimal gingival conditioning, and the correct choice of biomaterial can yield very predictable and fantastic aesthetic results. Objective: We aimed to use dental implants to rehabilitate the area of elements #11 and #21 in a satisfactory surgical and prosthetic manner, using guided surgery, connective tissue, nano-biomaterials, and a porcelain prosthesis. Case Report: A 32-year-old male patient presented with bone loss of elements #11 and #21, which was proven radiographically and clinically. Thus, oral rehabilitation with the use of dental implants was required. It was decided to proceed via digital planning with the DSD program (Digital smile design) and with the software Exoplan, (Smart Dent-Germany) whenever it was possible to plan immediate provisional and accurate dental implant positioning through reverse diagnostics (Software Exoplan, Smart Dent-German). The dental elements were extracted atraumatically; then, a guide was established, the implants were positioned, the prosthetic components were placed, the conjunctive tissue was removed from the palate and redirected to the vestibular wall of the implants, the nano-graft (Blue Bone®) was conditioned in the gaps between the vestibular wall and the implants, and, finally, the cemented provision was installed. Results: After a 5-month accompaniment, an excellent remodeling of the tissues had been achieved by the implants; consequently, the final prosthetic stage could begin, which also achieved a remarkable aesthetic result. Conclusions: This report demonstrates that the correct planning of dental implants, which is associated with appropriate soft tissue and bone manipulation, allows for the achievement of admirable clinical results.

Rheumatoid arthritis (RA) is an autoimmune disease that affects joint tissues and causes severe physical and functional impairments on quality of life due to muscular and articular pain. The involvement of temporomandibular joint in RA interferes with mouth opening and masticatory process. However, no studies addressed the impact of RA on oral health-related quality of life (OHRQoL) and satisfaction with prostheses use in elderly people. Aim: This study assessed the impact of oral rehabilitation with conventional dentures on the OHRQoL and prostheses satisfaction in elderly patients with RA, associated or not with temporomandibular disorder (TMD). Methods: Forty-five elderly were enrolled and divided into three groups: (1) RA and TMD (n=15, experimental), (2) RA without TMD (n=15, experimental), and (3) without RA and without TMD (n=15, control). The OHRQoL and the prostheses satisfaction were evaluated before and after new oral rehabilitation with partial and/or complete dentures. The OHRQoL and prosthesis satisfaction were assessed and verified through OHIP-14 questionnaire and visual analogue scale, respectively. Results: TMD group exhibited the worst mean values (P