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ePaper created 2015-11-12, 17:51:05 | version 1.38.0
case report _ guided implant surgery I of using stereolithographic guided surgery and overcomes some important drawbacks of stere- olithographic-involved procedures. _Case presentation The patient treated was a 21-year-old female consultingthedentalofficeforreplacementofboth secondpremolarsinthemaxilla,atregions#15and 25. The patient was in good general condition and a non-smoker. She had been treated before at the orthodonticdepartmentatGhentUniversityHospi- tal because of multiple dental agenesis. Intra-oral examination revealed the absence of both lateral incisors and second premolars in the maxilla and bothsecondpremolarsinthemandible.Periodontal screening showed no signs of pathology. The bone anchors used during the orthodontic treatment were still present in the second and fourth quad- rants. Treatment involved placement of two dental implants in the edentulous regions of the maxilla. Both implants were to be restored with two provi- sionalcrownswithin12hoursofimplantplacement (immediate loading). Preoperatively, an impression of the dental arch wastakenusinganirreversiblehydrocolloid(Cavex CA37, fast set, Cavex Holland) to fabricate a diag- nostic cast. This cast was used as a model for the moulding of the surgical stent; hereafter called NaviStent (Figs. 1a & b). The NaviStent served as a scanningtemplateandwasalsowornbythepatient during the surgery. Afterwards, the patient was sent for a CBCT scan with the NaviStent in place (Figs. 2, 3a & b, 4a & b). _Planning procedure AstandardCBCTscanwasperformedaccording totheprocedureoutlinedintheNavidentscanning protocol from ClaroNav. Cone beam images were takenwithaPlanmecaProMax3DMax(Planmeca) with a flat-panel detector and isotropic voxels. The field of view used for this case was 50mm x 100mm and a voxel size of 200µm. The exposition parameters were 96kV and 10mA. Care was taken to align the field of view with the jaw and the radi- ographic tracker, which was situated anterior of the jaw. Figs. 3a & b_Pre-op image of region #15 and a lateral photograph. Figs. 4a & b_Pre-op image of region #25 and a lateral photograph. I 19cone beam4_2015 Fig. 3a Fig. 3b Fig. 4a Fig. 4b