CAD/CAM - international magazine of digital dentistry

software. Moreover, it also enables implantation using the flapless technique. Im- mediate fabrication and use of the implant guide is even more important in imme- diateimplantplacementafter extraction of multi-rooted teeth, for which free-hand implantationisextremelydif- ficult (or near impossible). In addition to CEREC Guide, we can order and use the CLASSICGUIDE (SICAT), made on the basis of a conventional impression, or OPTIGUIDE (SICAT), a stent thatismanufacturedwithout bite plates and impressions, requiring only a digital scan of the patient’s mouth with CERECAC(Sirona)andaCBCT scanofthepatient’sjaws(us- ing GALILEOS or ORTHOPHOS XG 3D). Of all three guides that could be used, that is, a pilot drill, sleeve in sleeve or completely guided stents,onlyCERECGuidecanbeproducedinoffice immediately. CEREC Guide was used in the follow- ing clinical case report. _Clinical case report A55-year-oldmalepatient refused orthodontic treat- ment to move tooth 13 into proper position while making space for a replacement of tooth12.Thepatienthadbeen chewing on primary tooth 53, which was extracted about 14 days before implantation. Figure 1 shows the gap after extracting tooth 53. Tooth 12 was missing and tooth 13 had moved mesially into the space (Fig. 2). Overall, the patient was healthy and had no hereditary disease. In this case, we began the treatmentbytakingaconven- tional impression of the jaw in which we were considering placinganimplanttoreplacea missingtooth.Weusedquick- setting plaster well suited to fabricatingthestonemodel(Fig.3).Weplacedaref- erencebodyinthelocationofplannedimplantation on the stone model to determine the correct size (three sizes are available: small, medium and large). I 21 case report _ guided implantology I CAD/CAM 2_2013 Fig. 8Fig. 7 Fig. 6Fig. 5 Fig. 12Fig. 11 Fig. 10Fig. 9