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ePaper created 2018-04-10, 12:30:21 | version 1.38.0
| case report Fig. 20 Fig. 20: Dental panoramic tomogram of the patient for control of the final result. Subsequently, the implant navigation posts and the sur- gical template were removed in order to insert the gingiva formers in the maxilla, which were inserted to a torque of 25 Ncm (Figs. 18 & 19). The procedure in the maxilla was analogous to the operative implant bed preparation and insertion of the implants in the lower jaw, where six fully guided CAMLOG implants of 4.3 mm in diameter and 11.0 mm in length were inserted in regions #15, 14, 12, 22, 24 and 25. A postoperative dental panoramic tomogram showed the inserted implants in the maxilla and mandi- ble (Fig. 20). After the operation, the patient was instructed to cool and protect the operating area; a chlorhexidine gluco- nate mouthwash (0.2 %) was prescribed for one minute twice a day for two weeks after surgery and painkillers, if necessary. The patient was included in our implant maintenance programme and instructed on oral hygiene. Scheduled visits after surgery were after one week, two weeks and one month. At these visits, the healing process was found to be very good and painless. The definitive prosthetic restoration was planned for five months after the implantation. Discussion and conclusion The advancements in the field of implantology, such as 3-D imaging, implant planning software, CAD/CAM technology, and computer-guided and navigated im- plant surgery, have led to the digitalisation of implant dentistry and have taken implant prosthetic dentistry a major step forward. With significant achievements accomplished in the field of digital implant dentistry, implant placement has become highly predictable, even in patients where implant surgery was previously contra-indicated.6, 7, 14 contact Ioannis Papadimitriou St. Lukas Hospital Department of Oral and Maxillofacial Surgery Schwanenstraße 132 42697 Solingen Germany giannis.papadimitriou_4@hotmail.com 22 1 2018 Modern 3-D diagnostics enable detailed surgical planning of implantation, including prosthetic consider- ations. This achievement is mainly due to the continued improvement of implant planning programmes such as CTV software. CTV is used to display digital image data for diagnosis and precise prosthetic implant- oriented planning, with subsequent template-based implant placement.8, 13, 14 In conclusion modern implant navigation is based on sound systematic, prosthetic and surgical knowledge. It can optimise implant treatments and safely achieve the desired result, but it can never compensate for a lack of knowledge and surgical skill of the operator.11, 12, 14 Literature Author details