cone beam international magazine of cone beam dentistry

case report _ dental implantology I explained that he wanted a quick solution, with the caveat that he did not wish to be toothless at any time or to leave the practice with an obvious temporary restoration. A CBCT scan was obtained, along with a precise impression and bite registration. No major treat- ment was planned for the mandible. Owing to the fact that all the maxillary teeth required extraction, a treatment plan incorporating immediate seating of a full arch restoration was developed, for which the patient provided informed consent. The labo- ratoryfabricatedamaxillarymastercastalongwith a duplicate (Fig. 6), and the teeth were carefully removed preoperatively from the duplicate cast. The objective was to create an impression of aes- theticnaturaldentitionthatwouldnotsignificantly change the patient’s appearance. Aset-upwasfabricated,startinginonequadrant and using the other as a guide (Figs. 7 & 8). The sec- ond side was then completed. The new teeth were placed in ideal positions, and only minor aesthetic alterations were made. On a conventional denture set-up, the interdental spaces are filled with gingiva-coloured acrylic. In this case, however, the Fig. 5_The initial situation in the maxillae. Fig. 6_The initial situation in the mandible. Fig. 7_The duplicated master cast (frontal view) with the wax-up in the second quadrant. Fig. 8_The occlusal view of the master cast. Fig. 9_A new, improved situation with acrylic teeth (Genios, DeguDent) and wax, achieving the ideal function and aesthetics for our patients, here articulated. Fig. 10_The finished model with ideal tooth alignment is scanned. Fig. 11_The model’s surface with scan spray. Figs. 12 & 13_The sprayed model under the light of the scanner. Figs. 14a–c_The virtual models: one original with the existing dentition, after extraction on the model and finally the end situation to be achieved after surgery. Fig. 15_After the CBCT scan, all data was sent to the SIMPLANT software, where it was three-dimensionally matched. The image shows the eight implants in the bone with virtual axis elongation. Fig. 16_Design of the future restoration can be included in the implant plan according to the medical aspects. Figs. 17 & 18_The implant screw channels should ideally be situated in the centre of the tooth. Parallel design of the restoration and implants ensures that both are ideally suited. I 17cone beam2_2014 Fig. 18 Fig. 16Fig. 15 Fig. 17 Fig. 14 Fig. 13Fig. 12 Fig. 10Fig. 9Fig. 8 Fig. 11