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CAD/CAM - international magazine of digital dentistry - wydanie polskie

36 2_2014 CAD/CAM 36 case report _ CBCT and digital surface scanner I case report _ CBCT and digital surface scanner a digital surface scan of the left maxilla, left mandible and of both arches in maximum inter- cuspation to establish interocclusal contact was done with a TRIOS digital scanner (3Shape; Figs. 2 & 3b–d). Once all the diagnostic information had been gathered, a treatment appointment was made for the next day. The digital scan files and the DICOM files obtained from the CBCT were imported into the Implant Studio software (3Shape), in which an in- novative technique of spacial recognition allows the creation of a 3-D superimposition of the real intra-oral situation and the radiographic images. A restorative design tool included in Implant Studio was utilised to create a functional and aesthetic virtual crown with the ideal prosthetic position on the reconstructed surface image (Figs. 4a–d). After the final crown evaluation, the 3-D digital implant position was defined to obtain the most convenient prosthetic and surgical result, respecting vital structures, such as the inferior alveolar nerve and vascularity. Thus, the designedvirtualcrownwasusedasaradiographic template (Fig. 5). The planning can be performed using an intra- oral surface scan and can be checked with the cone beam 3-D reconstruction at the same time, assuring the optimum implant position and avoiding any bone fenestration or dehiscence (Figs. 6a & b). The implant selected was a Tapered Internal implant (BioHorizons; D 4.6 mm × L 10.5, platform D 4.5 mm). Once the implant position had been approved,ateeth-supportedvirtualsurgicalguide was designed (Figs. 7a–d). The final guide design Fig. 5_Multiple views of the 3-D digital implant positioning. Note how the designed virtual crown was used as a digital radiographic template. Fig. 6a_Implant planning performed using an intra-oral surface scan. Fig. 6b_Implant planning checked with the cone beam 3-D reconstruction. Fig. 7a_A lateral view of the guide design. The green line shows the future guide margin. Fig. 7b_The orange cylinder showing the screw exit for the future restoration. Fig. 7c_Virtual 3-D reconstruction of the surgical guide showing the screw exit of the future restoration. Fig. 7d_An angled view of the final surgical guide design and the insertion axis of the implant. 26 I cone beam2_2014 Fig. 7c Fig. 7d Fig. 7a Fig. 7b Fig. 5 Fig. 6bFig. 6a