Clinical Case: Gordon-E

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


Cast is cut at proposed implant axis


Implant angle based on prosthetic outcome. More buccal on site were premolar is

to be extracted, anticipating buccal boneloss.


Prototype BLP glued into place. Determining bucco-lingual position and the top of

the implant


Prototype BLP’s positioned for side by side implants


Surgical guide in place while tooth # 29 and pontic # 30 have not yet been

removed.


X-ray not shot perpendicular. Double view of RIR’s.

Current RIR’s are fully radio- opaque , while prototypes only on the outlines


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


Guided surgery does not mean flapless surgery


Foramen relative to tooth apex as visualized on PA radiograph


Very precise depth control is needed as we are close to the foramen , Drill set at

7 mm


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.


Implant placement and bone augmentation


Green line bottom of the implant


Actual distance between implant tip and foramen 2.9 mm, while on 2 dimensial

PA radiograph it would appear to be 1.4 mm


Non resorbable membrane protect bone augmentation and will develop abundant

keratinized gingiva.


8 weeks post placement


Restored with two single crowns

Clinical Case: Gordon-E

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