Abstract
Introduction: Full arch reconstruction with dental implants is considered as a reference for dental rehabilitation. However, there are some limitations with patient affected by severe maxilla, mandible atrophy and dento-skeletal-disharmony. These defaults can be corrected with orthognathic surgery and several bone grafts. Observations: A partially edentulous 65-year-old female patient with a skeletal class II by mandibular retrognathia was treated with mandibular advancement osteotomy and simultaneous insertion of four fully guided implants with immediate screwed zirconia prostheses loading in just one session. Conclusion: Simultaneous bilateral sagittal split osteotomy with a full arch rehabilitation by implant with immediate loading by zirconia prosthesis seems to be a reliable and predictable approach to treat skeletal class II patient with a fixed solution. Virtual planning was compulsory to be able to perform this surgery with accuracy.