cone beam international magazine of cone beam dentistry

14 I I special _ evolution of dental implantology piezoelectric sinus membrane elevation to sepa- rates the membrane without causing perfora- tions (Fig. 9). The concept of piezoelectric surgery has now been utilized for ridge-splitting, intra- oral bone harvesting from the ramus and chin, orthodontic procedures, impactions, distraction osteogenesis and much more. Other innovations for sinus grafting include the development of new surgical kits that include a variety of specially designed large and small diamond-coated drills for crestal and lateral ap- proaches to adding bone into the sinus without perforation (Fig 10). These instruments are avail- able from a variety of different companies that include predefined stoppers, sinus elevation in- struments, osteotome inserts allowing clinicians to perform a well-controlled maxillary sinus aug- mentation. _Restorative enhancements Therestorativephaseofimplantreconstruction has seen significant evolution in components, manufacturing processes, impression method- ologies, and materials. Perhaps the most impor- tanttechnologicalchangehasbeentheincreased use of CAD/CAM technologies for custom abut- ments, bar and prosthesis fabrication. Due to the fact that most implants may not be placed ideally, and that round implants are not true representa- tions of natural tooth morphology, custom abut- ments are a necessity for the restoration phase. The lost-wax casting method has many issues including the labor intensive method to fabricate custom abutments. CAD/CAM technology allows a higher degree of accuracy, consistency, im- proved emergence design and morphology, avoiding the porosities and distortion that can occur with analogue casting methods. In addi- tion, custom abutments can be fabricated from titaniumormoreaestheticmaterialslikezirconia. CAD/CAM bars for overdenture applications or as a base for fixed-detachable hybrid restorations have also benefitted from advances in computer design and highly accurate machining to create a significantly improved end-product. CAD/CAM technology has been now utilized to fabricate full arch restorations from monolithic zirconia pro- vidingenhancedstrengthwithoutcompromising aesthetics (Fig. 11). The evolution of dental implants will continue as the industry progresses in combining both the art and science of replacing lost intraoral anatomy and as dentistry remains committed to developing improved methods and materials to treat patients who require these services._ Editorialnote:Modifiedfromtheoriginalpublished in Compendium. © 2013 to AEGIS Publications, LLC. All rights reserved. Reprinted with permission from thepublishers. Fig. 9_A lateral window approach facilitated by piezo-electric surgery can be accomplished without damaging the soft tissue membrane. Fig. 10_Large and small diameter diamond-coated drills offer new solutions to lateral window and trans-crestal sinus grafting procedures. Fig. 11_A CAD/CAM designed implant-supported full arch monolithic zirconia restoration is planned on the computer screen. cone beam1_2014 Dr Scott D.Ganz currently maintains a private practice for Prosthodontics,Maxillofacial Prosthetics,and Implant Dentistry in Fort Lee, New Jersey,USA.Dr Ganz has been voted one of the “Best Dentists inAmerica,” “Top Dentists in New Jersey,”and served as Past President of the NJ Section of theAmerican College of Prosthodontists, and the ComputerAided ImplantologyAcademy (CAI). Dr Ganz delivers presentations worldwide on both the Surgical and Restorative phases of Implant Dentistry and has published extensively on these topics. He is considered one of America’s leading experts in the evolution of computer utilization and interactive software for diagnostic and treatment planning applications using CT and newer generation Cone Beam CT imaging modalities. cone beam_about the author Fig. 9 Fig. 10 Fig. 11 CBE0114_10-14_Ganz 31.01.14 15:50 Seite 4