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ePaper created 2015-03-07, 18:13:20 | version 1.33.01
I industry report _ implant treatment planning youtofillamissingspace.Itisuptoyoutooffertheideal restorative plan to fill that space first, then decide how youaregoingtoputtherestorativeplaninplace[bridge, implant; orthodontia]. So let’s do that. Design the ideal restoration,thenplanthemechanismtoholditin.) “OK,Mrs.Smith,itisveryimportantforyoutoreplace that missing tooth with a ‘tooth’ that will maintain the healthofyourmouthandwillprovideyoufunctionfor chewing.Wehaveseveraloptionstocompletethatgoal, but let’s first scan the area with an advanced 3-D laser scannersowecanplanaccordingly.” Take the Planmeca PlanScan and capture a true 3-D image of the area—all soft and hard tissue. (Note: No powder or contrast agent is placed. Think about it. Thispatienthasjusthadthetoothextracted,andthere isstillanopenorhealingwound.Thelastthingyouwant todoisspraytitaniumoxideunderpressureintoanopen orhealingwound.Sodon’tgothepowderroute.) “OK, so here is the 3-D virtual model. We can get a betterideaofwhattheidealrestorativesolutionwould be.Thecomputerwillassistusinpreviewingwhatwould be the best functional and maintainable solution for your individual case. Here is the ideal proposal, which we can optimize for your individual situation prior to doinganytreatment.” “It looks like one solution we should consider is asingle-toothimplantthatwouldholdtherestoration in place and also provide you the most natural feeling and natural-looking solution possible. But first we’ll need to look under your tissue to see if an implant is possibleinthatlocation.” TakeMrs.SmithovertothePlanmecaPromax(orany other compatible cone beam system) and complete aconebeamscan.Orifyou’vetakenonebeforeonany ofthecompatiblesystems,justgrabtheDICOMdata. “So now we can see the bone available below your tissue. I’m going to combine this data right on this screen and show you what is possible. Here is the im- plant solution I would recommend, and you can see I’ll placethisdirectlyundertherestorationwe’vedesigned and see if you have the type and amount of bone ideal forthisprocedure. “We’ll identify the location of the nerve that runs downyourlowerjawandcertainlyavoidthat.Withthis software, you and I can get a great view of the overall processbeforeanytreatmentisstarted.So,yes,itlooks likethiswouldbeanidealtreatment.” “If we decide to go with this, I have all the informa- tionIneed.Icanbereadywhenyouare,andinfact,Ican prepare a temporary restoration and have it ready to placeinthatspacethesamedaytheimplantisplacedso you’llneverfeelthatopenspaceagain.Yourtissueswill be able to heal in the ideal form, so when you’re ready, thefinalrestorationwillbethatmuchmorenaturaland beautiful.Let’sgetstarted.” PlanmecaRomexiswillguideyouintherightdirec- tion.Shareyourpassion._ Editorial note: This article was published in CAD/CAM C.E.MagazineNo.01/2014. 18 I cone beam1_2015 Fig. 6Fig. 5 Dr Curtis Jansen completed his DDS and his prosthodontic education at the University of Southern California (USC) School of Dentistry.He taught full time at USC and was director of implant dentistry in the Department of Restorative Dentistry.Currently,he has a full-time practice limited to prosthodontics and a dental laboratory in Monterey,California,USA. 34 Dormody Court,Monterey,Calif.93940,USA cejdds@mac.com,www.cejdentistry.com cone beam_about the author