Post on 31-Mar-2016
description
Copyright © 2011 Idondivi, Inc. All rights reserved.
Prototype : same concept different look
Categories : Posterior, grafting, multiple implants, prototype, Nobel
Biocare
2 Copyright © 2011 Idondivi, Inc. All rights reserved
Failing 3 unit bridge abutment tooth # 29
3 Copyright © 2011 Idondivi, Inc. All rights reserved
Cast is cut at proposed implant axis
4 Copyright © 2011 Idondivi, Inc. All rights reserved
Implant angle based on prosthetic outcome. More buccal on site were premolar is
to be extracted, anticipating buccal boneloss.
5 Copyright © 2011 Idondivi, Inc. All rights reserved
Prototype BLP glued into place. Determining bucco-lingual position and the top of
the implant
6 Copyright © 2011 Idondivi, Inc. All rights reserved
Prototype BLP’s positioned for side by side implants
7 Copyright © 2011 Idondivi, Inc. All rights reserved
Surgical guide in place while tooth # 29 and pontic # 30 have not yet been
removed.
8 Copyright © 2011 Idondivi, Inc. All rights reserved
X-ray not shot perpendicular. Double view of RIR’s.
Current RIR’s are fully radio- opaque , while prototypes only on the outlines
9 Copyright © 2011 Idondivi, Inc. All rights reserved
X-ray shot correctly, overlap RIR.
7 degree rotation block indicated to engage some native bone on the mesial , so
on purpose not following the existing alveolus
10 Copyright © 2011 Idondivi, Inc. All rights reserved
Guided surgery does not mean flapless surgery
11 Copyright © 2011 Idondivi, Inc. All rights reserved
Foramen relative to tooth apex as visualized on PA radiograph
12 Copyright © 2011 Idondivi, Inc. All rights reserved
Very precise depth control is needed as we are close to the foramen , Drill set at
7 mm
13 Copyright © 2011 Idondivi, Inc. All rights reserved
Very precise depth control is needed as we are close to the foramen , Drill set at
10 mm. Still short from the apex. In this way we are always safely away from the
foramen.
14 Copyright © 2011 Idondivi, Inc. All rights reserved
Implant placement and bone augmentation
15 Copyright © 2011 Idondivi, Inc. All rights reserved
Green line bottom of the implant
16 Copyright © 2011 Idondivi, Inc. All rights reserved
Green line bottom of the implant
17 Copyright © 2011 Idondivi, Inc. All rights reserved
Actual distance between implant tip and foramen 2.9 mm, while on 2 dimensial
PA radiograph it would appear to be 1.4 mm
18 Copyright © 2011 Idondivi, Inc. All rights reserved
Non resorbable membrane protect bone augmentation and will develop abundant
keratinized gingiva.
19 Copyright © 2011 Idondivi, Inc. All rights reserved
8 weeks post placement
20 Copyright © 2011 Idondivi, Inc. All rights reserved
Restored with two single crowns