CAD/CAM Magazine

14 I I case report _ implant surgery _The patient, a 62-year-old woman, was re- ferred by a local periodontist for an implant eval- uation. Her record stated that she was a “difficult patient owing to medical complications”. Her stated desire was that she wanted “to be able to chew”. Medicalhistory The review of systems was negative. The patient was a non-smoker and drank alcohol socially. She was allergic to iodine and took only hormone replacementmedication.Sheusedorganicproducts in her life whenever possible. She stated that she sufferedfrompersistent,recurringyeastinfections, which were exacerbated by any antibiotic use. She therefore refused antibiotics for any elective dental treatment. Diagnosticfindings The patient was healthy, her oral hygiene excel- lent and there was no evidence of active perio- dontal disease. Her cancer screening was negative. The temporomandibular joint was quiet with nor- mal range of motion, and she was missing teeth #1 to 4. Her initial radiographic assessment revealed a relatively low maxillary sinus in the area of the prospective implants. _Initial actions: December 2002 The patient was referred to an oral surgeon for an evaluation of her upper right maxilla. With a rel- atively low sinus, we determined that the patient would need a unilateral maxillary sinus lift and augmentation. This was discussed with the patient, who subsequently refused treatment owing to the need for perioperative antibiotic coverage for these procedures. She would also not accept a removable partial denture. She opted to initiate no further treatment at this time and desired only a regime of routine maintenance. CAD/CAM 2_2011 Fig. 1_Scan guide. Fig. 2_Scan guide with scan bite. Figs. 3 & 4_Procera software diagnostic work-up. Reducing surgical morbidity with CBCT- guided implant surgery Author_ Dr Daniel J. Velinsky, USA Fig. 1 Fig. 2 Fig. 3 Fig. 4