CAD/CAM - international magazine of digital dentistry

I case report _ guided surgery _Initial situation A 67-year-old patient presented to the dental practice for consultation on implant placement. The anamnesis revealed some specific conditions, particularly an allergy to dental metals. At this time, prosthetic restoration in the area to be reviewed consisted of an insufficient crown in the anterior region with an attachment mono- reducer-combination denture. Significant loosen- ingoftheabutmentteethintheanteriorregionwas found. Post and cores that had already loosened several times were found in the insufficiently filled root canals, probably due to monoreducer leverage (Fig. 1). The prognosis for conservative restoration was thought to be extremely poor. During the consultation, the patient expressed a preference for an implant solution. The patient also specified a cost limit. _Procedure Treatmentplanning For optimum assessment of the initial situation and subsequent treatment planning, after assessing the clinical situation, a dental panoramic tomogram diagnosis with intra-operative assessment of the im- plant site was favoured as method of choice (Fig. 2). This would take into account the minimally invasive therapeutic concept of surgical augmentation. Treat- mentwouldinvolvetheextractionofnon-conservable teeth and the immediate placement of a Straumann Bone Level implant in the region. Two implants were to be inserted in the premolar region. We planned to expand bone with the bone spreading technique and to use two Straumann Standard Plus Narrow Neck CrossFit implants (NNC) made from Roxolid implant material if the transverse bone at the site was com- promised.Prostheticrestorationwastofulfiltherequire- ments for an allergy-free dental prosthesis. The pros- thetic construction was to be manufactured with the StraumannCARESSysteminthein-houselaboratory. Bridge construction in the anterior region of the maxilla Author_Dr Steffen Wolf, Germany 28 I CAD/CAM 3_2013 Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6