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ePaper created 2016-09-20, 16:58:27 | version 1.38.0
Journal of Oral Science & Rehabilitation 52 Volume 2 | Issue 3/2016 I m m e d i a t e l o a d i n g u s i n g g u i d e d s u r g e r y Fig. 1 Initial clinical situation of a female patient with hopeless teeth in the maxilla. Figs. 2a & b Initial radiographic situation of a female patient with hopeless teeth in the maxilla. Fig. 1 Figs. 2a & b a b implant surgery; subjected to irradiation in the head and neck area less than oneyear before im- plantation; untreated periodontitis; poor oral hy- giene and motivation; uncontrolled diabetes; pregnant or nursing; substance abuse; psychiat- ric problems or unrealistic expectations; severe bruxism or clenching; immunosuppressed or im- munocompromised; treated or under treatment with intravenous amino-bisphosphonates; lack of opposite occluding dentition or prosthesis in the area intended for implant placement; activeinfectionorsevereinflammationinthearea intendedforimplantplacement;andneedofbone augmentation procedures at implant placement. D i a g n o s t i c p r o t o c o l Thepatients’medicalhistorieswererecordedand preoperative photographs (Fig. 1) and radio- graphs, including periapical (Figs. 2a & b) and panoramic radiographs, were obtained for initial screening and evaluation. Before implant place- ment, all ofthe patients underwent a cone beam computed tomography (CBCT) scan (New Tom VGi, Quantitative Radiology, Verona, Italy) ac- cording to a double-scan protocol.10 Atwo-piece radiographic guide was used for the diagnostic studyandthevirtualimplant planning according to previously described procedures (Fig. 3).21 In