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ePaper created 2016-05-19, 12:42:25 | version 1.38.0
industry | 312 2016 implants Fig. 8: Trying the wax-up. Fig. 9: Simple plate assisting in determining the implant position. Fig. 10: Flapless technology with punch. Fig. 11: The soft tissue removed. Fig. 12: Frontal view of the implants. Fig. 13: Occlusal view of the implants. Fig. 14: Placing of the open-tray impression posts. Fig. 15: Placement of the die. Fig. 16: Combination of posts and die with acrylic resin. Fig. 17: Three-dimensional position of the implants. Materials and methods General condition A 52-year-old female patient with missing two central incisor and one left lateral incisor (11, 21, 22). These teeth were extracted three months ago due to heavy caries. The patient requested implant therapy. The extraction points were healed and the gingiva was healthy. cone beam computed tomography (CBCT) showed sufficient bone height and width in the edentulous span, with 19.1 mm in height and 6.1 mm in width at the right central incisor alveolar bone, 14.9 mm in height and 6.2 mm in width at the leftlateralincisor.Thepatientwasingoodhealthand had no history of bruxism or other bad oral habits. The diagnosis was a dentition defect of the maxilla. Treatment design Two implants were placed in sites 11 and 22, im- mediate rehabilitation of the three teeth with a two-implant supported bridge and final prosthesis was made after six months. Materials One implant system (BEGO Semados RSX-Line, BEGO, Germany) and acrylic resin (PATTERN RESIN, Japan) were applied. Treatment protocol 1. Clinical examination was conducted before sur- gery. Assess of the quality and quantity was based on the CBCT. All conditions were fit the criteria for implant surgery. 2. Twoimpressionsweremadewithpolyethersilicone rubber and two plaster model were obtained. One was used to make the diagnostic wax-up on the edentulous sites and then hot press was applied to form a simple plate to guide the implants to be placed in an optimal position. A non-impression transfer die was made on the other one using acrylic resin, and two holes were made on sites 11 and 22 of the model. 3. Thediewastriedinbythecliniciantoensurestabil- ity. Plate and die were soaked in liquid with 75 per cent of alcohol for thirty minutes. 4. Implant placement was performed under local an- aesthesia (4 % articaine with 1:100,000 adrena- line).Thesimpleplatewasusedtoguidetheimplant to be placed in an optimal position. Then flapless implantsurgerywasconducted,twoimplantswere placedatthesitesof11and22(BEGOSemadosRSX 3.75 mm × 15 mm).The ISQ value of the two im- plants were 80 and the primary stability was Fig. 8 Fig. 10 Fig. 9 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 3122016