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Dental Tribune United Kingdom Edition

Best ever value cone beam CT Veraviewepocs 3D R100 & F40 Up to three times the image detail of other 3D X-ray systems Revolutionary R100 Reuleaux triangle full arch field of view Compact, versatile and affordable Extra clarity for implantology, endodontics and oral surgery Focus on the anatomy you need to see Up to six fields of view from 40mm to R100 Reuleaux arch Confidence of high definition, distortion-free radiographs High speed, high quality, low dose image Easy and accurate automatic scout positioning Multi-layer panoramic images Up to three times the image The Dental Imaging Experts G Comprehensive service and support plans G Independent specialists in digital X-ray systems Telephone: 0845 602 4944 Email: info@thedentalimagingcompany.co.uk FREE demonstration call 0845 388 3380 or email info@morita-uk.com See what you’re missing www.thedentalimagingcompany.co.uk NEW updated Conebeam A4 advert 9280.indd 1 17/10/2012 10:46 I mmediate loading of complete maxillary implant supported bridgework is an increasing request by patients who have high aesthetic and functional demands and attach great importance to a neat appearance and their self- image. Since 1977, positive results have been obtained in immedi- ate loading1, 2 but these were lim- ited to mandibular, bar-retained removable dentures. In 1997, Tarnow et al.3 published a study showing similar results for max- illary and mandibular full-arch, implant-supported bridgework, and, more recently, the focus has turned to the development of computer-based techniques for improved results. Highly so- phisticated technical tools such as Nobel-Guide (Nobel Biocare) and the SAFE SurgiGuide® (Ma- terialise Dental) have entered the market and related techniques such as All-on-4 (Nobel Biocare) are being promoted 4, 5 to help meet patients’ demands. All tech- niques are based on full maxillary bridgework with a screw-based retention. The screw-retained bridgework allows all procedures to be performed during the treat- ment ie impression taking, bridge modification and repair for aes- thetic or functional purposes. Amongst the more challeng- ing difficulties in carrying out such a therapy is implant posi- tioning, especially for a single crown in the anterior region. Precise placement is essential in achieving good aesthetics, pho- netics, function and cleanability. Most of the time, implant place- ment has to be within the limits of 0.5mm (Fig 1). Another factor to consider is the possible loss of alveolar bone after tooth extrac- tion, leaving a minimal residual volume, and thereby increasing the difficulty of the procedure. The positioning of implants depends on the guide’s positional accuracy in a definitive place at the time of the surgery and on the accuracy of the guide itself. In the case of NobelGuide, accurate positioning depends on the pa- tient’s ability to bite reproducibly and precisely, with even gingival thickness and consistency, and as- sumes that bone shows a similar degree of hardness at different screw-retention sites. Unfortu- nately, as recently reviewed by Schneider et al.6 and detailed by Valente et al.7 , the deviation be- tween entry point and orientation consistently differs between the TRIPOD - A new protocol for immediate loading Dr Jean-Nicolas Hasson et al looks at complete maxillary implant-supported prostheses page 20DTà ‘Amongst the more challenging difficul- ties in carrying out such a therapy is implant position- ing, especially for a single crown in the anterior region’ 19Implant TribuneNovember 19-25, 2012United Kingdom EditionUnited Kingdom Edition