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ePaper created 2016-01-26, 09:24:16 | version 1.38.0
I opinion _ 3-D technology Time was allowed for healing and a follow-up CBCT scan was taken to evaluate and treatment plan for the replacement of her only missing tooth. Additionally, I obtained an optical CEREC impres- sion to integrate with the CBCT imaging and restoratively plan the implant placement for this case. The data sets were merged and a restoratively driven implant was planned in preparation for the productionofanoptiguidesurgicalguide.Thistype of guide is completely digitally fabricated and was returned by Sirona’s SICAT production facility within 6 days. The bone graft used in this case is RTI biologics Puros mineralised allograft Cortico- Cancellous mixture covered by a resorbable colla- gen membrane, which resulted in regenerating a great volume of bone. You can clearly see the newly regenerated bone that was to receive the root form implant necessary to retain a screw-retained crown and return this patient to a full complement of teeth. This case required a flap approach, and the im- plant placed via the surgical guide without in- cidence, which I followed until it was fully inte- grated and ready to restore. It was necessary to alleviate this patient’s anxiety after placement to obtain a follow-up scan, which one can see how well the actual placement matched the virtual one (Fig. 37). The final restoration was torque in at 35 Ncm on 9th of February 2015. I expect this implant to have a long favorable life expectancy serving her well for many years to come (Figs. 38–40). The occlusion is handled like always by narrowing theocclusaldimensionsandprogrammeinasingle centric stop without over characterising the oc- clusal anatomy. Dr Carl Misch calls this occlusal scheme, implant protected occlusion. _Case 4—Extract, bone graft, and implant to replace the hopeless molar The last case took a similar course of action as the previous one. A patient complained months earlier of discomfort in his upper right quadrant, 16 I CAD/CAM 1_2016 Fig. 39 Fig. 40 Fig. 37 Fig. 38 Fig. 41 Fig. 42 Fig. 43 CAD0116_06-18_Ramirez 21.01.16 11:04 Seite 9 CAD0116_06-18_Ramirez 21.01.1611:04 Seite 9