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ePaper created 2015-11-12, 17:51:56 | version 1.38.0
3-D model also performed the actual surgeries. The potential locations for implant placement and corresponding implant lengths and widths were planned in a prosthetically driven manner. A dis- tance of at least 3 mm from the neck of the implant to the gingival zenith was applied, allowing the bi- ologicalwidthtocreateaconnectivetissuecontour around the abutments (Figs. 5 & 6). _Surgical procedure The surgery was performed under local and re- gional anaesthesia. Appropriate aseptic and sterile conditions were established to prevent postopera- tive infections. Before the start of the intervention, theNaviStentwasplacedovertheremainingteeth. It was primarily fixated using the undercuts of the remaining teeth and additionally by application of a denture adhesive (Corega, GlaxoSmithKline Consumer Healthcare). Beforestartingtheosteotomies,thedrillingaxis of the handpiece used during the surgical proce- dure was calibrated. The osteotomies were pre- paredatamaximumof500rpmusingtheNavident navigation system to guide the drilling procedure in real time by indicating the desired drilling path- way on the computer screen. Prior to the use of eachnewdrill,acalibrationprocesswasperformed (Figs. 7–9) in order to determine the exact location of the drilling tip. No punching of the gingival tis- sue was performed prior to the preparation of the implant sites. Before placement of each implant, an extra calibration procedure was performed in order to be able to track the implant itself also in realtimeduringinsertion.Thismeansthatboththe I case report _ guided implant surgery Fig. 5_ Planning in Navident. Fig. 6_ Planning in Navident. Fig. 7_Calibration of the drill axis. Fig. 8_ Calibration of the drill tip. Fig. 9_ Surgical guidance using Navident. Figs. 10a & b_Surgical guidance using Navident. Figs. 11a & b_Post-op image of regions #15 and 25. 16 I CAD/CAM 4_2015 Fig. 8 Fig. 9 Fig. 5 Fig. 7Fig. 6 Fig. 10a Fig. 10b Fig. 11a Fig. 11b CAD0415_14-17_Dhaese 06.11.15 11:58 Seite 3 CAD0415_14-17_Dhaese 06.11.1511:58 Seite 3