Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2015-03-07, 18:13:20 | version 1.33.01
I case report _ full-arch restoration _Osteogenic activation I performed osteogenic activation of the processedmaxgraftboneusedforsinusliftusingthe technique described by Scortecci. A trans-parietal approach was used for insertion of the Bone Matrix Osteotensor(Victory)afteraminimallyinvasiveflap- less protocol (Fig. 4). Endostealstimulationresultsinosteogenicacti- vation and allows evaluation of the mechanical strength of the grafted areas by probing. Owing to this simple and minimally invasive technique, the initialqualityofthefuturerecipientbonesiteiseas- ily assessed. These techniques have been success- fully used in orthopaedics for ten years. In view of the excellent response to osteogenic activation, it was decided that implants would be placed 45 days later. _Treatment planning ThecasewasplannedintheSIMPLANT(DENTSPLY Implants) treatment planning software. The scan prosthesis is critical for determination of the correct position and axial alignment of the implants; visuali- sation of the emergence profile; and determination of the size, position and axial alignment of the abut- ments.Furthermore,itallowsoptimaluseoftheavail- able bone height. At this stage, special attention shouldbepaidto3-Dpositioningoftheimplantsand particularlytotheemergenceprofileinordertofacil- itate the fabrication process of the final restoration. Straight or angled conical abutments are now clearly visible on the vestibulo-lingual cross-sections. Ten AxiomPXimplants(Anthogyr)wereplannedforamax- illary screw-retained bridge restoration (Figs. 5a-c). _Implant placement Implant placement was performed under local anaesthesia using the case-specific surgical guide. For thispatient,Iusedaspecificimplantdesign(AxiomPX, Anthogyr) with symmetrical double-lead threads(self- drillingandself-tapping)andareverseconicalneck(Fig. 6). Its unique design, combined with a special drilling protocol, promotes bone condensation even in soft bone,ensuringexcellentinitialfixation.TheBCP(bipha- sic calcium phosphate) sandblasting technique yields an implant surface with superior osteoconductive propertiesthatpositivelyinfluencethedevelopmentof osteoblasticcellsintheearlystageofosseointegration. A flapless technique was used for implant placement. Theflaplesstechniquehasdefiniteadvantages:preser- vationofthesubperiostealbloodvessels,andimproved patient comfort owing to a shorter operating time and simplepost-operativecare. Fig. 7a_Panoramic radiograph showing the temporary bridge placed 48 hours earlier. Figs. 7b & c_The high-rigidity temporary bridge made of cobalt–chromium and resin. Fig. 8_Healing status at six months post-op. Fig. 9a_The impression. Fig. 9b_The interconnected pick-up transfer copings. Fig. 9c_The wax bite block. Fig. 9d_The master model. 22 I cone beam1_2015 Fig. 7c Fig. 8 Fig. 7a Fig. 7b Fig. 9c Fig. 9d Fig. 9a Fig. 9b