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30 I I case report _ guided surgery The dental panoramic tomogram shows the situation 18 months after implantation (Fig. 33). The screw channels were filled with non-irritating PEMA16 in a trough-shaped final design. Then the final restorations were inserted (Fig. 34). _Conclusion The safety of the surgical methods and the augmentation materials used was of the highest priority in the patient information and treatment. The decision was therefore in favour of the body’s ownmaterials.Thisruledouttheriskofinfectionfor the patient, as well as immunological rejection of the transplant. “In its cancellous form, autologous bone […] is superior to all other bone substitutes with regard to its biological value, and is still con- sidered […] today to be the ‘gold standard’ among augmentation materials.”17 In addition, autologous bone is partially osteogenic and osteoconductive.18 When choosing the implant system, the focus was on the greater safety and better predictability in the early treatment phase with immediate load- ing. As a result, only an implant system with the SLActivesurfacewasanoption.Studieshaveproved 60 per cent more bone–implant contact19 with the SLActive surface after two weeks compared with the SLA surface.20 Immediate loading of Straumann SLActive implants achieves a survival rate in excess of 97 per cent after one year.21 Computer-aided, template-guided surgery via coDiagnostiX was used to place the implants. The procedure shows average horizontal deviations between the final and the planned position to 1 mm.22 Patients nowadays demand minimally invasive surgery, the shortest healing time possible and op- timal aesthetic results. Clinicians, however, are not only looking to satisfy their patients’ expectations, but also to obtain predictable long-term results. Bothdemandscanonlybeachievedthroughprecise planning and appropriate execution with excellent teamwork, as well as an implant product portfolio that offers perfectly matched components, from 3-D planning to the final restoration._ Acknowledgement: The authors wish to express thanks to Wassermann Zahntechnik for the drill templates and interim fabrication, to PKC Dental-Labor for fabricating the prostheses, and to Martin Holz (dental technician/ system expert at Straumann) for co-ordination, com - municationandstep-by-stepsupport. Editorial note: A complete list of references is available fromthepublisher. CAD/CAM 1_2014 DrRainerFangmannobtained aDoctorofMedicinedegree in1991andaDoctorofDental Medicinedegreein1995from theHannoverMedicalSchool inGermany.In1999,hewas awardedrecognitionasa specialistinmaxillofacial surgeryandoralsurgery.In2004,heobtained aMasterofSciencedegreeinImplantDentistry fromDanubeUniversityKremsinAustria. Since2003,hehasoperatedajointdentalpractice specialisinginoralandmaxillofacialsurgery andimplantologywithDrHelenaFangmann intheGesundheitszentrumSt.Willehad inWilhelmshaven,Germany.Heisaspeaker andtheauthorofscientificarticles. www.implantologie-whv.de Dr Lars Steinke has run his own practice with a focus on aesthetic dentistry in Schortens,Germany since 2004. www.dr-steinke.de CAD/CAM_about the authors Fig. 32 Fig. 33 Fig. 34 CAD0114_26-30_Fangmann 14.04.14 11:49 Seite 5