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ePaper created 2015-05-29, 13:18:43 | version 1.38.0
_Case 2: Limited mesiodistal space and proximity to the apices of the adjacent teeth A 20-year-old male patient presented with uni- lateral agenesis at region #12. This patient had just finished his orthodontic treatment. His brackets had been removed several months before. He was wear- ing a removable partial denture while waiting for the placement of an implant. The periapical radiographic examinations and CT scan cross-sections showed an extremely small mesiodistal space, especially at the level of the apices of the adjacent teeth (Figs. 14–16). The treatment of this small space required great precisionduringthesurgicalphase.Theinsertionaxis wasvisualizedonthe3-DreconstructionoftheCTscan cross-sectionsusingSIMPLANTsoftware(DENTSPLY). Preoperative periapical radiographs were performed at each drilling sequence. The treatment of this very small mesiodistal space was only made possible by the use of an implant of 2.8mmindiameter(Axiom2.8),withoutwhichitwould havebeennecessarytoresumeorthodontictreatment in order to align the apices of the adjacent teeth. That wasnotwhattheyoungpatientdesired(Figs.17&18). _Cases 3 and 4: Small antero-posterior volume Case3 A 25-year-old female patient at the end of ortho- dontic treatment presented with unilateral agenesis atregion#22.Thesmilelinewasmoderatelyhigh,as- sociatedwithright–leftasymmetryofthepositioning of the anterior teeth in relation to the midsagittal plane. The analysis of the CT scan cross-sections showedasmallbonevolumeonthevestibulo-palatal plane (Figs. 19 & 20). A narrow 2.8 mm × 12 mm implant was placed (Fig.21a).Theorthodonticarchwireservedasfixation during the osseointegration phase and was removed threemonthspostoperatively.Atemporarycrownwas fabricatedonaPEEKhealingpluginordertoshapethe peri-implant soft tissue. The permanent crown was to be fabricated four months after surgery (Fig. 21b). Case4 A 59-year-old patient came to our clinic with tooth #31 missing, which had been managed for Fig. 7_The impressions were taken with the pop-in technique. Figs. 8a & b_Master model with abutments. Fig. 9_Metal–ceramic crowns on the master model. Fig. 10_The crowns were seated outside the mouth and the unit was impacted with the Safe Lock instrument. Fig. 11_Safe Lock instrument and the different abutments. Fig. 12_Diagram showing the number of impactions required for permanent seating of the prostheses. 22 I cone beam2_2015 I case report _ CBCT in diagnosis Fig. 7 Fig. 8a Fig. 8b Fig. 11Fig. 10Fig. 9 Fig. 12