implants UK - the journal of oral implantology

14 I I case report _ CT-guided implant surgery implants1_2011 Fig. 15_Prepared siCAT surgical guide for Facilitate Surgical Guide. Fig. 16_Post-op panoramic CBCT reconstruction shwoing position of placed implants. Fig. 17_3-D reconstruction of post-op CBCT showing placed implants in the right maxillary posterior region in the 3-D imaging software (Fig. 5). Aprovisional abutmentwasplaced(Fig.6),andthepatientwassent to her dentist for a digital impression and fabricaton of a CEREC-produced provisional crown (Fig. 7). The procedure to remove the tooth and place the implant tookundertenminutes.Post-operativeGALILEOSscan images indicated accurate implant placement (Figs. 8 & 9). At the three-month follow-up appointment, the provisional restoration was stable. The gingival architectureandtissuehealthwereexcellent(Fig.10). _Case II This second case illustrates the tremendous power of the integration of GALILEOS and CEREC for treating the partially edentulous patient. This patient was a 62-year-old man with moderate bone loss due to smoking. He was otherwise healthy. He was missing teeth #2 to 5 and 15, and had under- gone bilateral sinus-lift surgery to augment the bony deficiency in the posterior maxilla (Fig. 11). In preparationforimplantplacement,aGALILEOSCBCT scanwasperformedwithasiCATscanningtemplate. A full-arch digital impression was acquired with the CEREC AC unit, and then prosthetic proposals were designed for teeth #2 to 5 and 15. This data was then imported into GALILEOS for implant plan- ning (Figs. 12 & 13). The position of the implants was verified (Fig. 14) and the surgical guide was ordered fromsiCAT(Fig.15).ThiswasusedtoplacefourAstra Tech dental implants accurately using the Facilitate Surgical Guide (Astra Tech). Post-operative ra- diographs demonstrated that all four implants were accurately placed and in accordance with the treatment plan (Figs. 16 & 17). The patient had an uneventful post-operative course. One of my favourite cocktails is the Vesper Martini, which was introduced to the world in the novel Casino Royale when James Bond asked the bartendertomixhimthisvariationonhisstandard drink. Bond named the drink after Vesper Lynd, his love interest in the story because, he confessed, as with her, once you’ve tasted it, that’s all you want to drink. CT-guided implant surgery is no different for me. After years of planning and placing dental implants the old-fashioned way I learned in residency, I was given a taste of a new way to do so. It was a radical change at first, but once I knew the recipe, I realised that it was a faster, better and more accurate way to treat my patients. Now, I can’t drink anything else. Hopefully, you will give it a taste and agree._ DrJayB.ReznickisaDiplomateoftheAmericanBoardofOralandMa- xillofacialSurgery.HereceivedhisdentaldegreefromTuftsUniversity,and hisMDdegreefromtheUniversityofSouthernCalifornia,andtrainedinOral and Maxillofacial Surgery at LA County-USC Medical Center. His special clinical interests are in the areas of facial trauma, jaw and oral pathology, dentalimplantology,sleepdisordersmedicine,lasersurgeryandjawdefor- mities.Healsohasexpertiseintheintegrationofdigitalphoto-graphy,3-D imaging,andCT-guidedimplantsurgeryinclinicalpractice. He frequently lectures at continuing education meetings, and has published articles in the JournaloftheAmericanDentalAssociation;JournaloftheCaliforniaDentalAssociation;Oral Surgery,OralMedicine,OralPathology,OralRadiologyandEndodontology;Compendiumof ContinuingEducationinDentistry;DentalTownMagazine;CEDigest;andGastroenterology. Dr Reznick is a founder of OnlineOralSurgery.com, which educates practising dentists in basicandadvancedoralsurgerytechniques.Heservesontheeditorialandadvisoryboards ofanumberofjournalsandorganisations.HeistheDirectoroftheSouthernCaliforniaCenter for Oral and Facial Surgery (www.sccofs.com) in Tarzana in California, and a consultant for variousdentalandsurgicalmanufacturers.Hecanbecontactedatjreznick@sccofs.com. _author info Fig. 15 Fig. 16 roots