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ePaper created 2018-02-16, 11:17:41 | version 1.38.0
| cone beam supplement dynamic navigation Fig. 25: Natural-looking final restoration. Fig. 25 osteotome and a heterogeneous bovine bone graft material (Bio-Oss, Geistlich) was introduced into the implant site (Fig. 15). A 4.5 mm diameter and 6.6 mm length Ankylos C/X implant was then placed 1 mm subcrestally (Figs. 16 & 17). Both implants had good primary stability on placement. Ankylos Balance posterior sulcus formers were fitted, without the need for additional closure with sutures (Fig. 18). The implants were restored four months after placement, with custom-made Dentsply Atlantis titanium abutments and Lava zirconia crowns (3M ESPE; Figs. 20–25)._ Implant placement in optimum bone contact Navident was used to guide the implant site preparation dynamically, to ensure implants were placed in the pre-determined position without the need for a static drilling guide. This facilitated place- ment of the implants in the optimum amount of bone without inadvertent damage to the maxillary sinus membrane. It also ensured that their align- ment made future impression taking and restora- tion straightforward. The ability to watch the drill virtually on the CBCT scan, as the implant sites were prepared, allowed the exact point at which to cease vertical drilling to be judged visually. Assessment, planning and placement were car- ried out within 48 hours, due to the patient’s lim- ited ability to attend for appointments. Using Navident, there is no reason why this could not be achieved in one visit. 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, he has striven to combine clinical perfection with the ultimate in patient care. He has been a willing pioneer of new technology, particularly in the field of digital dentistry. Dr Burgess was the first UK clinician to introduce the Navident dynamic navigation system into his implant treatment workflow, with the objective of achieving a higher degree of precision and greater patient comfort. He is also a member of the Dynamic Navigation Society as a Master Clinical Trainer, providing courses for implantologists who wish to experience how dynamic navigation can help to simplify their digital workflow. More information can be found on http://dns.claronav.com. Computer-guided navigation enabled the im- plants to be placed reliably and predictably within optimum bone, without the need to reflect a flap (Fig. 19). Consequently, the patient experienced no postoperative swelling or bruising and she re- ported very little discomfort after treatment. This outcome satisfied the primary objective of aiming for clinical perfection, whilst ensuring the patient experienced the least trauma possible. 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 46 CAD/CAM 4 2017