Dental Tribune United Kingdom Edition

May 7-13, 201214 Implant Tribune United Kingdom EditionUnited Kingdom Edition page 13DTß Fig 16_Transversal view at 14 Fig 17_Transversal view at 13 Fig 18_Transversal view at 12 Fig 19_Surgical template with ball reten- tion elements at positions 21, 15 and 25 for stable positioning of the template dur- ing drilling procedures. Careful cleaning and disinfection are mandatory before placement Fig. 20_Ball retentions on temporary im- plants for stabilisation of the temporary prosthesis, fixation of the scan template during cone-beam scan and positioning of the surgical template during the drill procedure Fig 21_The gingival punch is guided through the sleeves into the mucous mem- brane. The punch has no depth stop About the author Dr Claudio Cacaci is a specialist in oral surgery and implant dentistry. He studied at the Dental School in Munich and worked in the De- partment of Max- illo-Facial Surgery and the Department of Oral Surgery and Implant Dentistry in Munich. In 1997, he founded a private dental clinic with Dr Jan Hajtó in Munich. In 1998, he established the Private Training Centre for Implant Den- tistry (F.I.O.I.) in Munich. He is the founder of the Munich Study Group for Implant Dentistry and a member of various national and international study groups and dental associations. Dr Cacaci is author of the book Check- list – Implantology and contributing author of the book Manual of Oral Im- plantology. Since 2009, he has worked in a group practice specialising in implantology and periodontology in Munich. Fig 22_A scalpel is used to cut out and remove the punched gingival islands after removing the template Fig 23_Resected implant locations 26 and 27 Fig 24_The template is mounted again. Start of the CAMLOG Guide drilling sequence with the pilot drill followed by drills of the appropriate lengths depending on the implant length (region 23). Fig 25_Guided insertion through the sleeves utilising the CAMLOG Guide insertion tool Fig 26_The sleeve dimension allows for bone-condensing and bone-spreading procedures through the sleeve (here, osteotome for vertical bone condensation) Fig 27_Implants in first quadrant in situ. Depth stops on the surface of the sleeves Fig 28_Post-op panoramic radiograph Fig 29_Healing after one week post-op. The patient had neither complaints nor post-op swelling Fig 30_The surgical template is set back on its fabrication model. The analogue plaster reamers are used to create the cavity for the lab analogue through the sleeve Fig 31_Implant positions on the plaster cast Fig 32_Mounted lab analogues together with the insertion posts are secured to the sleeves with wax. The lab analogues are fixed into the plaster cast Fig 33_Cast with lab analogues in place. The transfer of the analogue into the correct position through the sleeve of the surgical stent Fig 34_A 0.5mm thick thermoformed splint is drawn over the abutments. The thermoformed copings perform the space-making task for passivation when cementing the interim restoration. Fig 35_Long-term temporary appliance in the articulator Fig 36_PEEK abutments in situ Fig 37_Long-term temporary appliance ce- mented in situ in terms of early treatment eight weeks post-op Fig 38_Impression with closed impression posts Fig 39_CAD/CAM-fabricated zirconia abutments bonded to CAMLOG Esthomic inset abutments Fig 40_CAD/CAM-fabricated zirconia abutments after one year in function Fig 41_Veneering work Fig. 42_Occlusal view before treatment Fig 43_Radiological situation before treatment Fig 44_Occlusal view two years after final prosthetic restoration Fig 45_Radiological situation two years after loading