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ePaper created 2018-01-31, 10:01:59 | version 1.38.0
| industry report Fig. 10 Fig. 11 Fig. 12 Fig. 13a Fig. 13b Fig. 13c Fig. 13d Fig. 13e Fig. 13f Treatment planning The treatment plan included the placing of six im- plants in the maxilla (Straumann BLT, 4.1 mm diameter, 12 mm length, Roxolid SLActive), followed by full recon- struction of the entire jaw (Figs. 10–13). The planned implant placement modality was type 1 (immediate, postextraction) and the planned loading modality was immediate loading. Lab staff received treatment plan- ning in preparation for surgery. implant beds were prepared according to the pre-sur- gical planning (Figs. 17 & 18). Next, six Straumann BLT implants (Roxolid SLActive) were placed (Figs. 19 & 20). Two tilted implants in the posterior maxilla were specif- ically used to avoid a sinus lift procedure and achieve very high primary stability. There was no need to use any biomaterials or bone grafting procedures. After implant placement, titanium bridges and a temporary abutment were placed, and primary closure of the flaps was obtained with a single suture (Fig. 21). Surgical procedure Prosthetic procedure Prior to the surgery, the patient was instructed in in- traoral professional hygiene and in a mouth rinsing pro- tocol. Antibiotic prophylaxis (amoxicillin 800 mg and clavulanic acid 200 mg) was also prescribed. Next, all the remaining teeth in the maxilla were extracted (Fig. 14), and a prosthetic guide was used to check its stability and correct orientation and congruity with the lower jaw (Figs. 15 & 16). A full-thickness flap was raised to ex- pose all recipient sites. A bone remodelling procedure was performed to remove thin parts of alveolar bone from the extraction sockets. Using the prosthetic guide, In accordance with our immediate loading protocol, a prosthetic surgical guide was used as an impression tray. This atypical impression was made directly us- ing a titanium temporary abutment as an impression transfer. A self-curing resin was injected to block abut- ments to the guide (Figs. 22 & 23). A full-arch tempo- rary bridge was then delivered and stabilised in the pa- tient’s mouth (Figs. 24 & 25). The patient was recalled after three days, one week and one month for suture removal, adjustment of occlusal contacts, and a gen- eral check-up (Figs. 26 & 27). 34 CAD/CAM 1 2018