CAD/CAM - international magazine of digital dentistry

I 25 case report _ guided surgery I CAD/CAM 3_2013 and 43, as well as a complete mandibular denture anchored by ball abutments (Figs. 1 & 2). After extensive counselling and discussion, we opted for a temporary fixed mandibular restora- tion on four implants with simultaneous explan- tation of the existing implants. Benefits of the selected restoration concept: _explantation, implantation and immediate resto- ration in one sitting; _a high level of safety owing to 3-D implant plan- ning; _durable temporary restoration with CAD/CAM high-performance plastic; _precision template-guided implantation with the CAMLOG Guide System; _high patient satisfaction with fixed screw-re- tained immediate restoration. _Pre-implantation planning Because the existing denture satisfied the basic aesthetic and functional requirements, the given situation was reproduced in plastic containing bar- ium sulphate according to backward planning. The desired prosthetic was fabricated from clear plastic withatitaniumreferencepinforthescanningtem- plate (Fig. 3). In order to make the prosthetic tooth axis visible in the CBCT scan, holes were drilled through the radiopaque teeth in the axis (Fig. 4). The DICOM data was then read into the coDiagnostiX implant planning system (Straumann). Computer-supported analysis offers the possibility of accurate diagnosis and planning the implants in agreement with anatomical and prosthetic require- ments (Figs. 5a & b). Positioning of the terminal im- plantsatanexact30-degreeangleisacrucialrequire- ment for the success of this treatment (Figs. 6 & 7). Fig. 6_Positioning of the terminal implants at an exact 30-degree angle. Fig. 7_View with the superimposed radiopaque components. Fig. 8_The scanning template was converted into a drilling template. Fig. 9_Preparation of the cast for model implantation. Fig. 10_The insertion posts in the required cam alignment with the screw-retained laboratory analogues. Fig. 11_Laboratory analogues placed into the cast. Fig. 12_The cast with screw-retained straight Vario SR abutments. Fig. 13_The Vario SR abutments with the Vario SR titanium caps. Fig. 14_Digitised cast situation. Fig. 19 Fig. 15 Fig. 27 Fig. 23 Fig. 14Fig. 13Fig. 12 Fig. 16 Fig. 17 Fig. 18 Fig. 20 Fig. 21 Fig. 22 Fig. 25Fig. 24 Fig. 26