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cone beam – international magazine of cone beam dentistry

I case report _ use of CBCT in implant dentistry Extendedhealingcapswerehandtightenedtothe implants. A postoperative radiograph was taken of theimplantsandthehealingcapstoensurecomplete seating. The immediate dentures were soft relined with a silicone-based soft denture relining material (UfiGelSC,VOCO).SomeoftheadvantagesIhaveper- sonally experienced with this material are that it is biocompatible, tasteless and odourless. By using the extendedhealingcapswiththesoftreline,theimme- diate dentures were much more retentive. The soft tissue and implants were evaluated clinically after one week. The patient stated that he had had very little postoperative discomfort or swelling. Within ten days, the patient returned to the prac- tice.Thesofttissuearoundtheextendedhealingcaps hadhealedverynicelywithahealthypinkcolour.Us- ing impression posts, full-arch impressions were takenwithInstantCustomC&BTrays(GoodFit).These custom trays can be adapted and fitted in minutes, eliminating the need for models, light-cured materi- als, monomers and extra laboratory time for custom impressiontrayfabricationbecausetheyaremadeof a material (PMMA) that becomes mouldable when heated (Fig. 9) and maintains its shape while cooling. Once the trays had been moulded for the patient, full-arch impressions were taken using a polyvinyl siloxane impression material (Take 1 Advanced, Kerr; Fig. 10). Bite relations, as well as instructions for size, shape and colour of the full-arch provisionals, were forwarded to the dental laboratory. With only a five- day turnaround, the custom abutments and provi- sionals were forwarded to the dental office and in- serted. The patient was very pleased with the aes- theticsandfunctionoftheseprovisionalrestorations. He was instructed about their care and use in eating, speaking and biting. Approximatelyfourmonthsaftertheinitialplace- ment of the dental implants, the patient returned for the definitive porcelain-fused-to-metal restoration impressions. The provisional restorations were re- moved using the Easy Pneumatic Crown and Bridge Remover (Dent Corp). Any temporary cement was re- movedandtheabutmentsinspected.Iftherewasany settling or recession of the gingival tissue, the abut- ments were modified using a carbide bur with copi- ousamountsofwaternottooverheattheabutments. This way, the margins could be brought right to or to slightly below the free gingival margin. A full-arch impressionwastakeninasimilarfashionfortheabut- ments and the provisionals. In addition, the relations between maxillary and mandibular arches were cap- tured. Within three weeks, the porcelain-fused-to- metal restorations were inserted and a panoramic radiograph taken (Figs. 11 & 12). In conclusion, an increasing number of patients are presenting to dental practices who seem to re- quire this type of reconstruction. By providing multi- ple services in a shorter number of visits with the use of CBCT and other technologies, the dental provider will find that more patients will accept treatment. In doing so, not only are you helping your patients regain proper form and function, but you are also helping them achieve a Total Dental Solutions Re- construction in fewer appointments._ Fig. 9_Good Fit Instant Custom Tray. Fig. 10_Full-arch impression. Fig. 11_Post-op panoramic radiograph. Fig. 12_Retracted post-op view. 12 I cone beam4_2015 Dr Ara Nazarian maintains a private practice inTroy in Michigan in the US with an emphasis on com- prehensive and restorative care.He has also conducted lectures and hands-on workshops on aesthetic materials and dental im- plants throughout the US, Europe,New Zealand and Australia. cone beam_author Fig. 11 Fig. 12 Fig. 9 Fig. 10

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