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ePaper created 2017-05-10, 16:12:25 | version 1.38.0
| cone beam supplement dynamic navigation Fig. 5: I was able to achieve the best buccal and lingual position of the implants, and their relation to each other and to adjacent teeth. Fig. 5 site is being drilled. Two Dentsply Ankylos® CX 3.5 mm diameter dental implants were placed sub- crestally in the lower left first and second molar sites, with implant lengths of 11 mm and 9.5 mm respectively. Avoiding damage to the inferior alveolar nerve was a crucial factor in the treatment planning of this case. Access was difficult, due to the limited opening of the patient's mouth. The issue was com- pounded by the plan to place an implant as distal as the second molar. These challenges were over- come using Navident's continuous internal visual feedback, which gave the author the confidence to use the optimum length of implant, whilst staying contact Dr David Burgess BDS DPDS MScConSed has been principal of Carbis Bay Dental Care in Cornwall since 1988 and has placed over 2,000 implants. Throughout his career, David has striven to combine clinical perfection with the ultimate in patient care. He has been a willing pioneer of new technology, partic- ularly in the field of digital dentistry. David was the first UK clinician to introduce the Navi- dent dynamic navigation system into his implant treatment workflow, with the objective of achieving a higher degree of precision and greater patient comfort. David Burgess is also a member of the Dynamic Navigation Society as a Master Clinical Trainer, providing courses for implantologists who wish to experience how dynamic navi- gation can help to simplify their digital workflow. More information can be found on http://dns.claronav.com Carbis Bay Dental Care 6–7 Boskerris Terrace St Ives Road, Carbis Bay, St Ives Cornwall TR26 2SF, United Kingdom Tel.: +44 1736 793090 carbisbaydental@btconnect.com www.carbisbaydental.co.uk 44 CAD/CAM 2 2017 within a safe distance from the inferior alveolar nerve and avoiding post-surgical complications, such as paraesthesia. Navident provided guidance for accurate im- plant location, even with restricted visibility and the drill being impeded by opposing teeth. Tactile feed- back can often be reduced when using a physical drill guide. Dynamic navigation removes this obsta- cle. The author was able to achieve the best-possible buccal and lingual position of the implants, and their relation to each other and to adjacent teeth (Fig. 5). This would allow for optimal shape, position and occlusal function of the final restorations. Ankylos® Balance posterior sulcus formers were fitted and the incision was closed with simple in- terrupted sutures . There was no need for bone aug- mentation. Two to three months after surgery, the implants will be restored with Atlantis® custom - made CAD/CAM titanium abutments and screw- retained linked zirconia crowns. Conclusion The clinical outcome was excellent. The planned placement was restoratively driven and the im- plants were well positioned, with good primary stability. Having used the Navident dynamic navi- gation system for more than a year, the author would not want to go back to preparing and placing dental implants without its 3-D visual guidance. The patient was comfortable and reassured, with no postoperative pain, swelling, bruising or par- aesthesia. He was delighted and, if he needed any implant treatment in the future, would insist on dynamic navigation._