Modern Tooth Replacement Strategies & Digital Workflow

Transcription

1 Modern Tooth Replacement Strategies & Digital Workflow Case Studies by Dr Maurice Salama, DMD AS PUBLISHED BY Dentistry Today, June 2014 Complete Implant Restoration System

2 FACTS: Implant Dentistry Has Become A Routine Procedure! Tooth Replacement Dentistry Can Be Highly Profitable! Cbct, Optical Scan And Digital Dentistry Will Be Mainstream! Increased Lifespan Will Increase Demand For These Procedures BENEFITS: Clinical Procedures Condensed = Fewer Appointments! Decreased Treatment Time = Higher Productivity! Increased Patient Comfort = Satisfaction! Better Results = Increased Referrals!

3 SURVIVAL A Retrospective Study of 1,925 Consecutively Placed Immediate Implants From 1988 to 2004 Barry Wagenberg, DMD 1 / Stuart J Froum, DDS 2 IMPLANT FAILURE BY LOCATION No of implants No of failures Failure rate (%) Maxillary Molars Premolars Canines Incisors Wohrle, PS Pract Periodont Aesthet Dent 1998 Kan, JY, Rungcharassaeng, K, Lozada, J Int J Oral Maxillofac Implants 200 De Rouck, T, et al Clin Oral Impl Res 2009 Block, MS, et al J Oral Maxillofac Surg 2009 Tortamano, P, et al Int J Oral Maxillofac Implants 2010 Cooper, LF, et al Int J Oral Maxillofac Implants 2010 Grunder, U Int J Periodontics Restorative Dent 2011 El-Chaar, ES Int J Periodontics Restorative Dent 2011 AUTHOR N = 390 SURVIVAL RATE % % 24 97% % 58 95% % %

4 OSSEOINTEGRATION Placement Should Be More Palatally Directed By 1-2mm Bone Grafting Of The Gap ALWAYS Immediate Non-Functional Provisional Improves Contour Ctg At Time Of Implant For Added Tissue/Ridge Thickness IMMEDIATE Tooth Replacement At The Time Of Extraction And Grafting Of Maxillary Premolar Ritter Spiral Implant Palatal Placement Bone Graft GAP

5 Ritter Scan Body Immediate Restoration Torque Insertion Minimum 40 Ncm No Lateral Forces On Implant Light Contact In Centric Only Within 72 Hours Of Implant Sx 3 Days Final Crown

6 Standard Implant Costs in Tooth Replacement Premium Implant Systems: $350 -$500+ (Implant Only) Impression & Temp Posts, Lab Analogues, Abutments, Screws: $280 - $450 Lab Prep, Custom Abutment (PRN) And/Or Final Crown: $290 - $500++ Total Cost Of Parts Surgical And Prosthetic Phases: $900 - $ Tooth Replacement In All Areas Staged Vs Immediate Approach Predictability Transitional Appliance During Healing Phase? PRN Less Technique Sensitive Tissue Stability

7 STAGED Tooth Replacement Following Extraction And Grafting Of A Maxillary Anterior Tooth

8 STAGED Tooth Replacement Following Extraction And Grafting Of A Maxillary Anterior Tooth Post-Trauma 3D CBCT IHB Diagnostics

9 Flap Design Spiral 30mm Implant 3D Placement

10 Soft Tissue Closure Essix Transitional Appliance

11

12 Before After

13 STAGED Tooth Replacement Following Extraction And Grafting Of Mandibular Molar Molar Area At 3 Months Ritter Transmucosal Placement Of Implant

14 6mm Wide Implant Ritter Transmucosal Placement Of Implant Ritter Scan Body Immediate Intra-Oral Optical Scan

15 STAGED Multiple Tooth Replacement Following Extraction And Grafting In The Posterior Maxilla Posterior Maxilla Tooth Replacement Shade Selection & Healing Abutment Posterior Maxilla Tooth Replacement

16 Internal Sinus Lift 5Mm Wide Implant Minimally Invasive Tooth Replacement After Optical Scan Healing Abutments Placed

17 Ritter 6mm Wide By 8mm Long Implant After Optical Scan Healing Abutments Inserted

18 Complete Implant Restoration System EVERYTHING FOR YOUR IMPLANT PRACTICE All Implants, Prosthetic Parts And Tools Everything Needed For Digital Or Analog Impressions COMPLETE CASE MANAGEMENT Pick-Up Of Impressions Managed To Your Or Any Restorative Referral s Specifications Through The Authorized Ritter Laboratory Network About CIRs Complete Cost Of All Components From Implants To Final Restoration: $595 Includes Surgical And Prosthetic Trays And Related Instruments High Quality Implants, Scan Bodies, Abutments, Screws Lab Service Includes Lithium Disilicate, Zirconium, Titanium CIRs Contract Includes Trios 3 Shape Scanner And Training Advantages of CIRs Minimizes Total Cost For Tooth Replacement Minimizes Chairtime Thereby Increasing Productivity Less Time For Patients In Chair And To Receive Restoration Optical Scanning Files Can Be Immediately Sent To Lab Most Treatment Can Be Performed On Day Of Implant Surgery

19 NOTES

20 Complete Implant Restoration System Ritter Dual Purpose Scan/Temp Abutment Healing Abutment Crown Tool Kit Drill 3Shape Scanner Restoration Abutment PUT-1S Pop Up Transfer Abutment (Platform=48) 1mm Shoulder 4mm Cone (Includes PUP-CA) Pop Up Transfer Abutment (Platform=48) 2mm Shoulder 4mm Cone (Includes PUP-CA) Pop Up Transfer Abutment (Platform=48) 1mm Shoulder 6mm Cone (Includes PUP-CA) Pop Up Transfer Abutment (Platform=48) 2mm Shoulder 6mm Cone (Includes PUP-CA) Pop Up Transfer Abutment (Platform=48) 1mm Shoulder 8mm Cone (Includes PUP-CA) Pop Up Transfer Abutment (Platform=48) 2mm Shoulder 8mm Cone (Includes PUP-CA) Pop Up Transfer Abutment (Platform=48) 3mm Shoulder 8mm Cone (Includes PUP-CA) Pop Up Transfer Abutment (Platform=48) 4mm Shoulder 8mm Cone (Includes PUP-CA) PUT-2S PUT-1M PUT-2M PUT-1L PUT-2L PUT-3L PUT-4L Analog for Pop Up Trans Analog -PUT-S UT-M Temporary Cap (4mm) for PUT-S TC-PUT-S TC-PUT-M Temporary Cap (6mm) for PUT-M Temporary Cap (8mm) for PUT-L TC-PUT-L eve for PUT-S, M & L Non-Engaging (Red) T UP-CA pression Plastic cap for PUT-S, M & L Waxing Sleeve for PUT-S, M & L Engaging (White) WS-PUT-R ACCESSORIES PUT System Dental Surgical Guides Complete Case Management Services Implants