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CAD/CAM - international magazine of digital dentistry

26 I I case report _ guided surgery _Fabrication of the drilling template and immediate restoration The position of the implant determined during 3-Dimplantplanningwastransferredtothedrilling template in the dental laboratory using the gonyX coordinate table. The guiding sleeves with depth stops from the CAMLOG Guide System were pre- cisely bonded on to the scanning template, thereby converting the scanning template into a drilling template (Fig. 8). Inordertofabricatetheimmediaterestoration,a model was required. Corresponding cavities were incorporated into the cast (Fig. 9). The CAMLOG Guide insertion posts were then used to insert the laboratory analogues into the cast (Fig. 10). It was important here to position the insertion posts with thescrew-retainedlaboratoryanaloguesaccording to the required cam alignment Fig. 11). Figures 12 and 13 show the Vario SR abutments and Vario SR titanium caps on the cast. Alaserscannerwasthenusedtodigitisethecast (Fig. 14). In order to simplify the CAD of the imme- diate restoration, it made sense to superimpose the desired prosthetic situation defined by backward planning over the existing situation (Fig. 15). The design was created with DentalDesigner (3Shape; Figs. 16 & 17). After a suitable milling strategy had beendetermined,thedatawastransferredtoafive- axismillingmachine.Atooth-colouredPMMAblank was used as the material of choice (Figs. 18–20). In contrast to traditionally fabricated temporary solutions,CAM-fabricatedimmediaterestorationsdis- tinguish themselves by their high resistance to frac- ture.Thispropertyisanimportanttechnicalrequirement for complication-free function of the restoration. In ordertoachievepleasingaesthetics,gingiva-coloured Fig. 15_Desired prosthetic situation superimposed over the cast situation. Fig. 16_The CAD restoration was created with DentalDesigner. Fig. 17_The second molars were omitted. Figs. 18 & 19_CAM of the restoration (Fig. 18) using a tooth-coloured PMMA blank (Fig. 19). Fig. 20_Detailed preparation of the occlusal surfaces. Figs. 21 & 22_Aesthetic customisation using gingiva-coloured plastic, basal (Fig. 21) and labial (Fig. 22). Fig. 23_Adequately sized bonding gap for intra-oral bonding. Fig. 24_Explantation of the one-piece diameter-reduced implants. Fig. 25_The explants. CAD/CAM 3_2013 Fig. 32 Fig. 33 Fig. 34 Fig. 35 Fig. 28 Fig. 29 Fig. 30 Fig. 31 Fig. 40 Fig. 41 Fig. 42 Fig. 43 Fig. 36 Fig. 37 Fig. 38 Fig. 39