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case report _ use of CBCT I and sometimes for bone-borne templates. Addi- tionally, due to the anatomical restrictions in the mandibular posterior area (i.e. diminished alveolar ridge,vitalstructures),itisimperativethatthecom- puter-aided surgical guide be as stable as possible to ensure accurate drilling, and to avoid potential complications. The present case report demonstrated how the useofpre-existingimplantscanbeusedtoaidinthe planning phase, and for intraoral fixation and stabi- lization of the CT/CBCT-derived surgical template. It was helpful that the pre-existing implants had Lo- catorabutments,originallyusedtostabilizeanover- denture prosthesis. Using interactive treatment plan- ningsoftware,receptorsitesweredeterminedforthe placement of six additional virtual implants to be combined with the original implants to support a new fixed-detachable immediate transitional res- toration.Theabilitytoassessboththepositionofthe originalimplants,andthenewimplantreceptorsites in harmony with the restoratively-driven placement was important to achieve a successful outcome. The enhanced capabilities of 3-D imaging and interac- tive treatment planning software were combined with the fabrication of a 3-D printed biomedical model of the mandible to facilitate the utilization of the original Locator abutments to improve the stabilization of a bone-supported surgical guide. The clinical protocol insured predictable and accu- rateresults,whilehelpingtoreducepatientmorbid- ity. The technique demonstrated in this case report may be applicable to other case presentations when there is an opportunity to utilize pre-existing im- plants as a method to achieve increased template stability._ _References 1.Sarment DP, Sukovic P, Clinthorne N. Accuracy of implant placementwithaStereolithographicsurgicalguide.IntJOral Maxillofac Implants 2003;18:571–577. 2.Tahmaseb A,Wismeijer D, Coucke W, Derksen W. Computer technology applications in surgical implant dentistry: a sys- tematic review. Int J of Oral Maxillofacial Implants 2014; 29(SUPPL):25–42. 3.BrautV,Bornstein MM,Kuchler U,Buser D.Bone dimensions in the posterior mandible:a retrospective radiographic study using cone beam computed tomography.Part 2 –Analysis of edentulous sites. Int J Periodontics Restorative Dent 2014; 34.5:638–647. 4.Rathi N, Scherer MD, McGlumphy E. Stabilization of a com- puter-aided implant surgical guide using existing dental im- plants with conversion of an over-denture to a fixed prosthe- sis.J Prosthodont 2014; doi:10.1111/jopr.12174 5.Regli CP, Kelly EK.The phenomenon of decreased mandibu- lar arch width in opening movements.J Prosthet Dent 1967; 17:49–53. 6.Ganz SD.The triangle of bone – a formula for successful im- plant placement and restoration. The Implant Society Inc 1995; 5(2):2–6. 7.Ganz SD. Using interactive technology: in the zone with the triangle of bone.Dental Implantology Update 2008;19:5. 8.Zmener O, Banegas G, Pameijer C. Bone tissue response to a methacrylate-based endodontic sealer: a histological and histometric study.J Endo 2005;31(6):457–459. 9. Schnitman PA, Hwang JW.To immediately load, expose, or submerge in partial edentulism:a study of primary stability and treatment outcome. Int J Oral Maxillofac Implants 2011; 26(4):850–859. 10. Pagliani L, Sennerby L, Petersson A, Verrocchi D, Volpe S, Andersson P. The relationship between resonance fre- quency analysis (RFA) and lateral displacement of dental implants: an in vitro study. J Oral Rehabil. 2013 Mar; 40(3):221–7. Figs. 12a–d_Post-operative radio- graphs of the final implant positions, and the pre-existing implants. I 15cone beam1_2015 Dr Barry Kaplan, Prosthodontist,Bloomfield, N.J.,USA.Past President of the NJSectionoftheAmericanCol- lege of Prosthodontists,Fellow of the International Congress of Oral Implantologists (ICOI). www.kaplandentistrynj.com cone beam_about the author Fig. 12a Fig. 12b Fig. 12c Fig. 12d