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CAD/CAM - international magazine of digital dentistry

| opinion 3-D technology 32 CAD/CAM 2 2016 communicating the extent of my patients’ condi- tions and the comprehensive nature as to what is necessary to return them to a full complement of teeth and oral health. Patients unaware of the de- struction caused by bacterial infection, poor den- tistry and neglect are very difficult to convince that they require extensive dental treatment to improve their oral health. Since I have the benefit of 3-D im- aging, their conditions can be displayed on a large computer screen, which facilitates an interactive conversationwhichgenerallyresultsintheirunder- standing their problems and moving forward with the necessary treatment presented. It is especially useful when evaluating bone deficiencies, periapi- cal pathology, evaluating existing periodontal sup- port and residual bone volume in edentulous areas. Allofthefollowingcasesbenefitedviaadvanced3-D imaging to gain a complete understanding of the enormity of the obstacles these patients faced prior to commencing with treatment. The case presenta- tion visit explained clearly how advanced implant dentistryandpropersequencingwouldprovideeach patient with their desired result. The goal for each was to rehabilitate these patients with an aesthetic and fully functioning maxillary arch of new teeth. Theyallweregivenoptionstoreplacehopelessmax- illary arches with the guarantee being that their prosthetic replacements would look and function much better than their failing natural dentition. WhatfollowsishowIdiagnosed,treatmentplanned, case presented and treated three decimated maxil- lary arches. As you read my applications of the 3-D differenceandtheeventualtreatments,thinkabout howthesecaseswerepositivelyimpactedbytheuse of 3-D imaging and how its use led to case accep- tance and facilitated positive patient experiences, eventhoughthesecaseswereascomplexandchal- lenging as exist in the dentistry today. Where do we begin? All three patients presented with a common prob- lem, hopeless maxillary dentitions due to years of neglect, fear and poor maintenance of their natural dentitions. These types of situations are complex and challenging to treat. Each case required the re- moval of all maxillary natural teeth, but psycholog- ical complexities made for the unique treatment plans developed. It took a lot of courage for these patients to finally decide that they were ready to proceed with a treatment to improve their condi- tions. The decimated dentition requires managing the whole patient and the 3-D difference increases theabilityformypatientstounderstandandaccept treatment. My office has a distinct advantage over offices lacking the technology. The first patient accepted her fate of an immediate complete upper denture, prior to guided implant placement and replacing her teeth with an implant retained metal reinforced horseshoe CUD overden- ture.Thesecondpatientwasnotreadytoacceptthe immediatecompleteupperdenturesoshewouldbe transitioned into a four unit implant retained re- Fig. 12a Fig. 12b Fig. 9 Fig. 10 Fig. 11 22016

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