Accelerated Patient Rehabilitation

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Alexandrina Wilkins
8 years ago
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1 Accelerated Patient Rehabilitation Providing The Tools Necessary For An Immediate Solution: NanoTite Implants QuickBridge Provisional Components Navigator System For CT Guided Surgery

2 Initial Patient Presentation A 70-year-old male presented with advanced periodontal disease. As a result, extraction of all natural teeth in the maxillary arch was deemed necessary (Figure 1); however, a removable denture was not an acceptable solution for this individual. The recommended treatment plan was to provide the patient with an immediate fixed-provisional restoration supported by dental implants. Required processes included CT guided implant placement and delivery of an immediate fixed provisional prosthesis during the same visit. Fig. 1 Pre-Operative Planning A CT scan of the patient was taken in conjunction with a scanning appliance. Data from the CT scan was converted and transferred into a planning software program. Here a 3-dimensional model of the patient s anatomy was generated from the CT scan data, allowing for the surgery to be planned virtually. Both implants and abutments were selected in the software, to provide the appropriate patient specific result (Figure 2). Fig. 2 Photograph courtesy of: Materialise Dental The scanning appliance allows for the visualization of the desired provisional restoration within the CT scan in relation to the tissue and bony anatomy of the patient.

3 Surgical Procedure From the virtual treatment plan, a Surgical Guide and Surgical Plan were created and sent to the clinician. The Surgical Guide was designed to fit the patient s individual anatomy. Master Tubes were positioned within the guide to enable the execution of the surgery, as planned in the software. As immediate provisionalization was determined in the treatment plan, the Surgical Guide was sent to the dental laboratory for fabrication of the provisional prosthesis. The day of surgery, osteotomy preparation and NanoTite Implant placement were performed through the Surgical Guide with the Navigator Surgical Instrumentation. This guided procedure ensured controlled implementation of the treatment plan with regards to all aspects of implant site preparation and placement including position, depth, angulation and hex-orientation of the implants. Minimally invasive procedures were performed in a flapless approach to reduce healing time and patient discomfort (Figure 3). Fig. 3 Following implant placement, the Surgical Guide was removed and Conical Abutments were selected and secured into the implants (Figure 4). QuickBridge Titanium Cylinders and PEEK provisional caps were placed and the temporary restoration was tried-in intraorally. Seating of the provisional restoration was confirmed and acrylic resin was flowed into the relieved areas to set the QuickBridge Caps within the provisional restoration. The restoration was removed to fill voids, trim and polish and then was reseated intraorally. Occlusal adjustments were made as necessary. Fig. 4 Accelerated Solution In one short visit, the patient left with a fixed provisional restoration supported by multiple implants. In this minimally invasive procedure, swelling and pain were minimized, resulting in shorter healing time and accelerated function for the patient (Figure 5). For a more detailed case presentation visit and click on In The Operatory. Fig. 5

4 Accelerate Your Practice s Success With BIOMET 3i Innovative solutions developed by BIOMET 3i to assist with accelerating patient rehabilitation*: The NanoTite Implant: The NanoTite Implant Surface has a unique deposition of nano-scale Calcium Phosphate (CaP) Crystals that increases the micro-complexity of the implant surface topography. The Navigator System For CT Guided Surgery: The Navigator Instrumentation enables preparation and implant placement, allowing for the delivery of a pre-fabricated provisional prosthesis immediately following implant placement. QuickBridge Provisional Components: Provide a simple solution for the fabrication of multiple-unit, cement-retained, provisional restorations on definitive Conical Abutments. *Rehabilitation is considered the restoration of aesthetics and function. Note: All chewing function may not be restored with a provisional restoration.

5 The Right Tools This Surgical Plan provides step-by-step instructions as to the instrumentation to be utilized to implement the virtual treatment plan intraorally. A Surgical Plan is generated to accompany each Surgical Guide. Navigator Analog Mounts are used with the Surgical Guide to position implant analogs and fabricate a working master cast. The master cast replicates the intended intraoral surgical implant placement including hex-orientation. This allows for the creation of the provisional prosthesis, which is delivered immediately following implant placement.

Clinical Perspectives

Clinical Perspectives Inside This Issue: Accelerated Patient Rehabilitation With Advanced Technologies Case Presentation By: Pär-Olov Östman, DDS, PhD, MD Åsa Kärner, CDT Volume 8, Issue 2 Advanced Technologies