CAD/CAM - international magazine of digital dentistry

I 27 case report _ guided surgery I CAD/CAM 1_2014 root canal (Fig. 1). The patient requested reha- bilitation with a fixed prosthesis. As a result of years of wearing removable prostheses, the mandible revealed an atrophy pattern of resorp- tionClassV–VIontherightandCawoodClassIVon the left.1 _Procedure Treatmentplanning Bone augmentation with autologous material from the retromolar region/corpus of the respec- tive sides and delayed implantation was discussed with the patient. She requested a preoperative 3-D image (Fig. 2) to clarify the necessity of augmentation. Three-dimensional planning with coDiagnostiX (Dental Wings) for implant place- ment and immediate restoration via Multi-Base Abutments (Straumann) was recommended after augmentation. Surgicalprocedure The patient requested general anaesthetic dur- ing bone augmentation. This was followed by the typical incision of the gingival margin and ap- propriate mesial and distal relieving incisions. Once the dimensions of the receiving site had been determined, the corresponding mandibular ramus and/or corpus site was selected. After determining the dimensions and the morphology of the bone graft, the mono-cortical bone block was harvested from the donor site2, 3 bypiezo-surgery4 (Fig.3).UsingaSafescraper(Meta Advanced Medical Technology),5 this was thinned down extra-orally to a final thickness of 1 mm. The thinned block served as a biological membrane to stabilisetheparticulatebonematerialvestibularlyand orally. First, a cortical lamella was fixed occlusally over the osteosynthesis retaining screws in gliding holes(Fig.4).Thislamellawaslinedwithcorticalchips Fig. 13 Fig. 10 Fig. 7Fig. 5 Fig. 6 Fig. 8 Fig. 9 Fig. 11 Fig. 12 CAD0114_26-30_Fangmann 14.04.14 11:48 Seite 2