CAD/CAM international magazine of digital dentistry No. 4, 2016

EAO meetings | 53 CAD/CAM 4 2016 Digital technology can support dentists in several steps of restorative treatment, from cone beam computed tomography and the virtual planning of implant positions through to prosthesis manufac- ture for immediate function. Also, virtual planning can be transferred to the actual clinical setting by fabricating surgical guides for flapless implant placement. The main advantage of digital techniques is the ability to plan and optimise the positioning of im- plants in a prosthetically driven manner. Moreover, computer-guided techniques can help decrease postoperative discomfort and allow immediate function, as they enable implant placement with minimal surgical trauma. In addition, these tech- niques can offer a useful alternative to bone augmentation in severely resorbed jawbone, as they facilitate optimal positioning of implants in the available bone. In your lecture at this year’s EAO congress in the “Things we stopped in our practice due to fail- ures” session, you discussed immediate CAD/ CAM restoration. What are potential complica- tions of immediate CAD/CAM restoration, and why is this treatment approach prone to failure? Although computer-guided techniques for implant placement can offer advantages for both the dentist and the patient, guided implant surgery is technically demanding and not free of specific procedure-related complications. For example, the drillingtemplatemayfractureortheremaybecom- plications related to limited access and visibility when using a flapless approach. This can lead to deviations in implant positioning and ultimately a poorly fitting prosthesis. Moreover, high aesthetic demands may be difficult to completely foresee, sincecomputer-guidedimplantpositioningcarries the risk of overlooking the ideal location of an implant with regard to the soft tissue. Therefore, theskillsandexperienceofaclinicianwhowantsto use these techniques need to go far beyond those necessary for regular implant surgery. What alternative treatment protocol do you recommend for less experienced clinicians? A good option is to use digital techniques for im- plant placement in combination with traditional protocolsforprosthesismanufacture.Forexample, a template-guided flapless surgery for implant placement can be combined with a traditional pro- tocol for unloaded healing and the fabrication of a permanent prosthesis._ Dr Margareta Hultin is a senior lecturer at the Department of Dental Medicine at Karolinska Institutet in Stockholm in Sweden and has more than 15 years of experience in research and education in implantology. © Anne Faulmann/DTI 42016

Pages Overview