CAD/CAM - international magazine of digital dentistry

26 I I case report _ guided surgery CAD/CAM 1_2014 _Introduction Patients with fixed restorations in the form of large-spanbridgesoftenwishtoretainafixedsolu- tion, even if the distal bridge abutments have been lost. Yet prosthodontists advise a shift in treatment to a removable prosthesis. This is due to a lack of knowledge of current possibilities regarding bone augmentationandimplantation.Theargumentthat implant-borne (fixed) restorations promise quality oflife,appealandyouthfulnessisignored.Asacon- sequence, removable restorations are only partially accepted and result in patient dissatisfaction in the long term. The desire for permanent rehabilitation remains. The opportunity for immediate placement of an implant and, if necessary, augmentation of the posterior section of the mandible to address resorption is missed. _Initial situation A 71-year-old female non-smoker in a good general and nutritional state presented with multiple prosthetic restorations in the maxillae, consisting of bridges and single crowns placed at different times. The mandible revealed an in- sufficient denture. Tooth 43 had been destroyed by caries under the crown and had a treated Fig. 1 Fig. 2 Rehabilitation of an atrophic mandible with 3-D planning Authors_Drs Rainer Fangmann & Lars Steinke, Germany Fig. 3 Fig. 4 CAD0114_26-30_Fangmann 14.04.14 11:48 Seite 1