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ePaper created 2015-05-29, 13:18:43 | version 1.38.0
technique _ first part of an implant treatment I 3-Dpositioning As regards replacement of a lateral maxillary inci- sor, the tolerances for the location of the implant are verysmallbecauseofthenarrowwidthoftheimplant corridor. Two recent meta-analysis13,14 concerning the precision of surgical guides resulting from 3-D imagery, even if these do not apply specifically to the lateral incisor replacement, has found a deviation in the order of a millimetre at the point the implant emergesand4to5degreesasregardsthedrillingaxis. For Van Assche et al.,14 the average imprecision at the apex of the implant is 1.24mm. Since these measurements are incompatible with a12or22implantcorridor,itisimportanttocheckthe first drill hole(s) during the operation, whether the surgery is guided or being carried out freehand. If the implant clinic does not have retroalveolar X-ray equipment, portable generators such as the Anyray 2 (Vatech)areavailableonthemarket,whichallowyou to produce intraoperative images (Fig. 16). In this context the Precision Drill from the Nobel Biocarekitsisparticularlyhelpful.Itssharppointpro- vides considerable precision at the point of entry and its small dimensions make it possible to correct any deviations from the ideal axis occurring during the first drilling (Fig. 17). In the vestibular palatal plane, it is essential to prepareaprosthetictreatmentplanbeforeinserting the implant because the positioning requirements differ: Fig. 22_Creation of flap envelope, Swann-Morton blade through the envelope. SM 63, inlaid with transparency. Fig. 23_Passage of suture through the envelope. Fig. 24_The palatal flap is folded into the vestibular envelope using a suture thread. Fig. 25_Tissue integration with ceramic crown. Fig. 26_Vestibular bulge obtained with modified flap. Figs. 27a-c_Clinical and X-ray views, vitroceramic in place. I 17cone beam2_2015 Fig. 22 Fig. 23 Fig. 24 Fig. 25 Fig. 26 Fig. 27a Fig. 27b Fig. 27c