Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-08-25, 17:58:13 | version 1.38.0
| cone beam supplement use of CBCT and CAD/CAM The use of CBCT and CAD/CAM techniques in complex implant-supported rehabilitation of maxilla—Part II Author: Dr Tomasz Śmigiel, Poland Fig. 2 Fig. 4 In the first part of this article (published in CAD/CAM 1/2017) the different phases of diagnostics, planning and implantological treatment were presented. In the process of planning, the necessity of creating tempo- rary restorations in order to increase the patient’s comfort was taken into consideration, keeping in mind the fact that augmentative procedures must be performed. Once the implants—located at lateral sections of the maxilla both on the right- and left-hand side—had integrated, it was possible to proceed to the process of designing and building the final construction of the prosthetic restoration. The integration period took considerably longer than in the case of frontal sec- tions of the maxilla because of the necessity of per- forming a sinus lift procedure. The patient was very well protected as he had been using a skeletal prosthesis based on four telescopic abutments at the frontal section. Benefits arising from such a solution consisted not only in the feeling of comfort, but also in the fact that the frontal im- plants were subject to functional loading immedi- ately after the period of initial integration, which has resulted in the surrounding bone being subjected to the process of condensing thanks to regular training. Another advantage was the fact that there was no need to disassemble the telescopic abutments on the implants at the frontal section as the abutments had primary telescopic crowns, while the secondary ones had been prepared as a second set for placing within the final construction. The final prosthetic restoration included a bridge attached to four implants, and on four telescopic abutments based on a TRINIA framework, which was created by means of CAD/CAM techniques, onto which zirconia based porcelain crowns were glued. The remaining part of the structure was veneered by means of a pink composite material in order to imitate the gum. Fig. 1 Fig. 3 Fig. 1: A virtual image of a scanned model with abutments and telescopic crowns. Fig. 2: Design of the construction with the transparency mode on. Fig. 3: Ready-made construction on a virtual model. Fig. 4: Scan of the temporary prosthesis (blue color) visible against the design of the construction. 50 CAD/CAM 3 2017