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cone beam – international magazine of cone beam dentistry

I case report _ guided implant surgery surgery using a surgical template. A radiographic guide was constructed by duplicating the denture and placing eight to ten gutta-percha markers throughout the oral cavity. Gutta-percha markers should be placed at 1–2 mm intervals for the best results (Fig. 3). Two CBCT scans were acquired: firstly, a scan of the patient wearing the radiographic guide and a radiographic guide index (bite index) to ensure that the radiographic guide was securely placed in the patient’s mouth, and, secondly, a scan of the radi- ographicguideitself(double-scanmethod).Theac- quired data was imported into OnDemand3D soft- ware (Cybermed), and edited and merged by means of the In2Guide module (Fig. 4). The implant planning was performed according to the nine-step procedure of the patient CT and radiographic guide option of the In2Guide module (Fig. 5). The final implant planning data was up- loaded to the OnDemand3D server, and the surgical template was manufactured accordingly and deliv- ered on time (Fig. 6). Surgicalprocedure The surgery was performed under local anaes- thesia. The remaining teeth, except for one (vertical dimensionplaceholder),hadbeenremovedapprox- imately six weeks earlier. The surgical protocol of a delayed implant placement was applied. In order to fix the surgical template in place, three anchor pins were placed (Figs. 7 & 8). In accordance withthesurgicaltemplate,fourICXimplants(meden- tismedical)wereinsertedinter-foraminally,applying the one-stage protocol. After the implant surgery, the last remaining tooth was removed (Fig. 9) and a postoperative panoramic radiograph was acquired (Fig. 10; SCANORA 3D). As the next step, a provisional implant-borne prosthesis was fabricated and seated (Fig. 11). The finalrestorationwasperformedapproximatelythree to four months later. _Discussion and conclusion The literature supports the use of CBCT in dental implant treatment planning, particularly with regard to linear measurements, 3-D evaluation of alveolar ridge topography, proximity to vital anatomical struc- tures and fabrication of surgical guides. Areas such as CBCT-derived bone density measurements, CBCT- aidedsurgicalnavigationandpost-implantCBCTarte- facts need further research. Fig. 5_In2Guide module options. Fig. 6_Final implant planning. 16 I cone beam4_2015 Fig. 5 Fig. 6

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