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ePaper created 2015-11-12, 17:51:56 | version 1.38.0
osteotomy preparation and the implant placement processaretrackedinrealtime.TheNavidenttrack- ingsystemusesanon-screenvisualrepresentation of the surgical area and auditory cues to aid the clinician (Figs. 10a & b). Two XPEED AnyRidge implants (Megagen) were installed. At region #15, an implant of 4 mm in lengthand13mmindiameterwasplaced,whereas at region #25 an implant of 10 mm in length and 3.5 mm in diameter was placed (Figs. 11a & b & 12). After completion of the dental implant place- ment, a crown-lengthening procedure was per- formed in the anterior maxillary region in order to ameliorate the aesthetic outcome. It is beyond the purpose of this report to provide any detail regard- ing this procedure. _Prosthetic procedure Immediately after implant placement, impres- sion copings (Megagen) for an open-tray impres- sion were screwed on to the implants and hand torqued (Fig. 13). An impression was taken at im- plant level using a silicone material (Permadyne Penta H, 3M ESPE Dental) in a plastic Position Tray (3M ESPE Dental). Within 8 hours, two temporary screw-retained acrylic teeth were delivered to the patient and connected to each of the implants. Theacrylicteethweredesignedbasedontemporary titanium abutments. Occlusion and articulation were checked and corrected wherever necessary. All superstructures were hand torqued to a maxi- mum of 15 Ncm. No cantilevers were allowed on the provisional structures in order to avoid exten- sive non-axial forces. Postoperatively, the patient received a prescription for antibiotics (amoxicillin 1,000 mg, b.i.d., four days), non-steroidal anti- inflammatory drugs (ibuprofen 600 mg, t.i.d.) and a mouthwash (chlorhexidine 0.12%, b.i.d.). After one week, a postoperative visit was scheduled. No signs of infection or inflammation were present and healing was uneventful (Figs. 14 & 15). _Conclusion With a two-week postoperative follow-up, this was the first immediate loading procedure based on the Navident navigation surgery system. The patient reported no pain or swelling associated with the dental implant procedure. Further post- operative results are being tracked and reported as part of a pilot study being conducted at Ghent University (Figs. 16a & b)._ Editorial note: A list of references is available from the publisher. case report _ guided implant surgery I Fig. 12_Post-op panoramic image. Fig. 13_Post-op photograph of the maxillary occlusal surfaces. Fig. 14_Post-op frontal photograph. Fig. 15_Post-op photograph of the maxillary occlusal surfaces (post-loading). Figs. 16a & b_Post-op lateral photographs of the restorations in regions #15 and 25. I 17CAD/CAM 4_2015 Fig. 15 Fig. 16bFig. 16a Fig.12 Fig. 14Fig. 13 Dr Jan D’haese Ghent University Hospital De Pintelaan 185 9000 Gent Belgium Jan.dhaese@ugent.be CAD/CAM_contact CAD0415_14-17_Dhaese 06.11.15 11:58 Seite 4 CAD0415_14-17_Dhaese 06.11.1511:58 Seite 4