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Dental Tribune United Kingdom Edition

implant placement. The sur- gical guide snaps firmly over the existing teeth, expanding over and undercuts, becoming a very stable platform to drill through. The Astra Facilitate soft tissue punch is used to re- move the overlying soft tissue, and a standard drilling proto- col using the Sirona drill keys is used. A high primary stability of 40Ncm was obtained, with a 4mm healing abutment placed immediately. The patient healed with no pain, no swell- ing and no discomfort. The post op LCPA corresponds well with the pre-surgical planning with an ideal angulation for a screw-retained crown. After two months of healing a fix- ture level open-tray impres- sion was taken and cast up using an Astra Tech replica. A standard metal abutment was inserted into the replica and cut back by 3mm from the occlusal table. This was then powdered and scanned using the Ac BluCam and an Ivoclar e.max CAD C14 block milled. The CEREC 4.2 software was instructed to mill a hole that corresponds to the screw in- sertion path on the abutment. This is finalised using a high speed diamond bur with copi- ous irrigation. The crown is glazed and sintered, allowed to cool and bonded to the abutment using Vario link II. The final crown can be screwed directly into the im- plant and a final check for con- tacts and occlusion is made. This process shows just how far CAD/CAM technol- ogy has come. An implant can be planned, inserted and re- stored all in-house, using the current available technology. The final result is equal to any lab-based restoration al- beit for simple units. The pro- cess does have its limits for multiple span bridges, and multiple implant placement, especially in edentulous ar- eas. As the technology devel- ops, with further advances be- ing made, the scope of what’s possible for the implant den- tist is always expanding. DT Fig 4: Reference body and thermoplastic guide in-situ prior to CBCT scan Fig 5: CBCT with reference body and Cerec proposal overlay ‘An implant can be planned, inserted and restored all in-house, using the current available technology’ January 21-27, 201312 Implant Tribune United Kingdom Edition page 11DTß