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implants the international C.E. magazine of oral implantology

I case study_ flapless implant placement Fig. 2_A screenshot from the Navident software showing the digitally planned crown and implant (yellow) placement. Fig. 3_The drill is shown here being calibrated on the Fig. 2 Fig. 3 JawTag, which is fixated to the NaviStent in the patient’s mouth. Fig. 4_The clinical view of the handpiece being used to drill the osteotomy as it is being guided on the monitor. Note the DrillTag shown above attached to Fig. 4 Fig. 5 the surgical handpiece that allows it to be tracked. Fig. 5_A screenshot showing the Navident software navigating screen while the drill (in green) is being live guided against the CBCT cross sections. The CBCT cross-sectional views as well as the target bull’s eye on the left allow the Fig. 6 Fig. 7 surgeon to navigate the drill to the ideal digitally planned position. Fig. 6_An immediate postoperative clinical view of the surgical implant site, showing the flapless surgery of the single-stage implant-guided placement with a healing abutment. Fig. 7_ Postoperative peri-apical radiograph showing a Straumann Bone Level Tapered 4.1x10 mm implant placed with an internal sinus elevation. 12 I implants 1_2017 the ridge. The CT marker was then fixed to the stent by way of a thumb screw. The NaviStent with the attached CT marker was placed into the patient’s mouth. The stent was checked for stability in the patient’s mouth. A CBCT scan was completed for the entire maxillary arch, being sure to include the arm of the CT marker, which contains the aluminum fiducial. The CBCT scan was then imported into Navident software. The Navident software automatically reg- isters the fiducial and asks you to inspect the registra- tion to ensure there is no malalignment. Our implant position is prosthetically determined, so our first step was to place a virtual crown at the 2.5 (13) site. The vertical height of bone from the ridge to the sinus floor was measured using the software measuring tool and found to be 7.4 mm (Fig. 2). Our treatment plan involved placing a Straumann Bone Level Tapered SLActive Roxolid 4.1 mm x 10 mm implant as a single-stage flapless approach with an internal sinus elevation. Taking advantage of the freedom of the Navident system, we were able to plan our surgery to place a Straumann dental implant and complete our internal sinus lift using the HIOSSEN CAS-KIT (Crestal Approach Sinus Kit). To control our drilling depth and use the live navigation to guide us to the sinus, a digital implant was placed in the ideal location with respect to the digital crown. This digital plan would guide us to the sinus floor for the sinus elevation and allow ideal implant placement. _Live navigation implant surgery and internal sinus elevation The patient was seated for the implant surgery. Local anesthetic was given. The single-use JawTag was fixated to the NaviStent with the provided thumb screw. The tag adapter was mounted onto the surgical handpiece and fastened in place, accord- ing to the company’s instructions. The single-use DrillTag was attached to the tag adapter on the surgical handpiece. The NaviStent was placed into the patient’s mouth with the JawTag visible for the Navident camera to detect. Once the CT markers are visible by the camera, they become visible on the side panel on the moni- tor. The next step was to calibrate the drill axis by placing the handpiece head onto the calibration peg present on top of the JawTag. The handpiece was

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