cone beam international magazine of cone beam dentistry

case report _ dental implantology I aesthetic appearance (Fig. 41). The second tempo- raryrestorationwasfabricatedbyhandinthelab- oratory utilising the 3-D printed model and was based on a metal substructure (Fig. 42). Each restorationwasdesignedtobewornbythepatient throughout the anticipated three to six months of osseointegration. When both restorations were compared, they were the same size, but the hand- made restoration appeared to be distinctly stronger (Fig. 43). When it was placed on the 3-D model, the aesthetic appearance was also satis- factory. Thesurgicalprocedure Surgery was carried out under general anaes- thesia in the Princess Grace Hospital Centre in Monaco. The teeth were extracted and the extrac- tion sockets were meticulously cleaned (Figs. 46 & 47).Agingivalflapwasreflectedsufficientlytoal- low for the bone-supported surgical guide to be positioned on the alveolar ridge (Fig. 48). It fitted perfectly. The surgeon then followed the implant- specific drilling protocol to prepare osteotomies for the eight implants (ANKYLOS C/X, DENTSPLY Implants; Fig. 49). The implants were placed alter- nately with the specially designed carriers that allowed for placement through the guide. The im- plants were strategically positioned and secured to prevent the guide from tipping and then block- ing the implants with the positioning aid (Figs. 50 & 51). Once the surgical guide had been removed, Balance Base Abutments (ANKYLOS, DENTSPLY Implants) were connected (Figs. 52 & 53). and overcrossed to prevent the guide from tipping. Fig. 51_Blocking the placed implants with the positioning aid. Fig. 52_The implants with the SIMPLANT SAFE guide in their original position. Fig. 53_The situation after removal of the surgical guide. Fig. 54_Securing the Balance Base Abutments. The terminal implants were not immediately loadable, as there was insufficient bone substance in those areas. Fig. 55_Insertion of the GORE-TEX membrane and replacement of the missing bone with Bio-Oss. I 21cone beam2_2014 Fig. 49Fig. 48 Fig. 46Fig. 45 Fig. 55Fig. 54 Fig. 52Fig. 51 Fig. 44 Fig. 47 Fig. 50 Fig. 53