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ePaper created 2016-01-26, 09:24:16 | version 1.38.0
I opinion _ 3-D technology prosthetic design that is developed to return the patients dentition to form and function. I am able tocreateaplanbasedontheavailableboneandthe future positions of the prosthetics. Study models were obtained and duplicated so that the labora- torycouldcreateawaxupofthefourmissingteeth in their correct occlusion. I duplicated the wax up and made a .060 omnivac suck down which repre- sented the crowns in their proposed positions. Within this omnivac I inserted radiopaque acrylic in the area of teeth #28–31 and attached a SICAT proprietary biteplate with acrylic, which became the radiographic scan appliance worn while the CBCT scan was taken. It is necessary to scan the patient with a Sirona proprietary biteplate secured overthepatients’dentitionsothatSICATcanmerge thedatasetsfromthe3-Dimagingandthepatients dentition. I can then place the virtual implants in theirbestpositionsrelativetotheproposedcrowns and bone volume present. Following the scan, a definitive implant plan is created that will mimic the actual dimensions of the Nobel Active implants to be placed at the time of surgery. Sirona provides its clients with a vast library from which to choose whatever implant manufactureryouprefertoworkwith.Thisensures that my plan will be executed properly with the osteotomies performed to my specifications at the surgical visit. Submillimeter accuracy from plan to actual is a clear benefit derived from enhanced imagingandadvancetreatmentplanning.Isentthe CBCT data and a cast of the patient’s dentition that SICAT optically scans and integrates with the im- plant plan that I created and used to mill out and fabricate the surgical guide. It takes two weeks to receive an accurately fitting Classic SICAT surgical guidebackinmyofficewhichwouldbeusedduring patient’s guided implant surgery. The Sirona system is the only complete system that doesn’t require a third party software or man- ufacturer to create their surgical guides. Figures 8–10showthevirtualimplantsplacedintothearea of tooth #28, 30 and 31. Please note the measure- ment taken buccal-lingually at the #28 site and the anatomical limitations dictated by the lingual concavities present at the #30 and #31 sites. Some compromises were necessary to ensure safe, predictable and long lasting success of our im- plants. They were dictated by the anatomical bone limitationspresentandthepatients’refusalforany additional bone grafting. ImplantSurgery The surgical visit was scheduled and I placed the patientonAmoxicillin500mgtobetakentwodays priortohisimplantsurgeryandcontinueduntilthe prescription was completed. Patient presented on the 9th of January 2014 and was anxious but ready to proceed with his implant placement. An inferior alveolar block with local anaesthesia was given and was effective to produce profound anaesthe- sia during our treatment. Osteotomy preparations were completed in a timely manner and three 10 I CAD/CAM 1_2016 Fig. 18 Fig. 19 Fig. 15 Fig. 16 Fig. 17 CAD0116_06-18_Ramirez 21.01.16 11:02 Seite 5 CAD0116_06-18_Ramirez 21.01.1611:02 Seite 5