Dr. Meir Mamraev, DMD,. LLB,. - The Future of Dental Implants Reports/Guided Surgery - Case...
Transcript of Dr. Meir Mamraev, DMD,. LLB,. - The Future of Dental Implants Reports/Guided Surgery - Case...
Dr. Meir Mamraev, DMD,. LLB,.Graduated from Dental school of Iasi University in 1992 and Law
school of Ono College in 2005.One of the founders of Cortex company. Senior Vice
President of research and Developmentat Cortex dental implants industries LTD.
Head of postgraduate training programs and academical activities of Cortex.
Worldwide lecturer as well as an owner of a private dental practice in Tel-Aviv, Israel.
CASE 1............................................3-7
CASE 2............................................8-11
CASE 3............................................12-18
CASE 4............................................19-22
CASE 5............................................23-27
INDEX
3
CASE 1 (Dr. Meir Mamraev – Israel)
Diagnostics
Age: 59
Gender: Female
Periimplantitis: 27
Roots #13, #15, #11, #21, #22, #23, #24 deep caries and fractured crowns with no option for rehabilitation. General Health: good
Digital files: CBCT scan & Digital impression
4
CBCT SCAN
MODEL STL
PANORAMIC X-RAY
CASE 1
5
Treatment Plan
1. Prosthetically driven virtual implant planning- 3Shape Implant Studio: Safety Zone – apical distance – 2.0 mm
Safety Zone – radical distance – 1.5 mm
Position #15: Ø3.8 / 11.5mm – Dynamix Conical
Position #12: Ø3.8 / 11.5mm – Dynamix Conical
Position #22: Ø3.8 / 11.5mm – Dynamix Conical
Position #23: Ø3.8 / 11.5mm – Dynamix Conical
Position #27: Ø3.8 / 11.5mm – Dynamix Conical
CASE 1
6
2. Guided Surgery - Cortex Guided Surgery Kit + Cortex Guiding sleeves
Teeth extraction #13, #14, #11, #21, #22, #23, #24, implant #27 removal Implant placement: #12, #15, #22, #23, #27 Immediate full arch temporization, including existing implants #16, #17, #25, #26
3. Surgical guide
4. Immediate temporization with PMMA total bridge on Multi-units. Implant #27 was not loaded. Operation
Operation Date: 23/10/2018 Flapless procedure Execution of the treatment plan
CASE 1
7
Clinical Follow-Up including X-ray and dates
Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
14 12
22
27 25
CASE 1
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CASE 2 (Dr. Meir Mamraev – Israel)
Diagnostics
Age: 77
Gender: Female
Teeth #44, #45, #46, #47 are missing
General Health: good
Digital files: CBCT scan & Digital impression
9
Treatment Plan
1. Prosthetically driven virtual implant planning - 3Shape Implant Studio Safety Zone – apical distance – 2.0 mm
Safety Zone – radical distance – 1.5 mm
Position #44: Ø3.8 / 13mm – Dynamix Conical Position #46: Ø3.8 / 10mm – Dynamix Conical
CBCT SCAN
MODEL STL
CASE 2
10
Position #47: Ø4.2 / 8mm – Dynamix Conical
2. Guided Surgery- Cortex Guided Surgery Kit + Cortex Guiding sleeves 3. Implant placement position #44, #46, #47 4. Surgical guide
Operation
Operation Date: 21/10/2018
Flapless procedure Guided surgery for implant placement 44, 46, 47
CASE 2
11
Clinical Follow-Up including X-ray and dates
Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
Implant 44
Implant 47
Implant 46
CASE 2
12
CASE 3 (Dr. Meir Mamraev – Israel)
Diagnostics
Age: 64
Gender: Male
Fully edentulous lower case
Old removable denture
General Health: good
Digital files: Dual scanning protocol:
CBCT of denture with 3D markers
CBCT of the same denture inside patients’ mouth
13
CASE 3 Treatment Plan
1. Prosthetically driven virtual implant planning- 3Shape Implant Studio Safety Zone – apical distance – 2.0 mm
Safety Zone – radical distance – 1.5 mm
Position #32: Ø3.8 / 11.5mm – Dynamix Conical Position #33: Ø3.8 / 16mm – Dynamix Conical
CBCT of the denture inside patients’ mouth CBCT of denture with 3D markers
CASE 3
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Position #42: Ø3.8 / 11.5mm – Dynamix Conical Position #43: Ø3.8 / 16mm – Dynamix Conical
2. Guided Surgery- Cortex Guided Surgery Kit + Cortex Guiding sleeve Implant placement in positions: #32, #33, #42, #43 + 3 fixation pins for guide stabilization. Immediate temporization- total PMMA bridge fixed on Angulated multi units.
CASE 3
15
3. Surgical guide
PMMA bridge, Digital model Analog & Surgical Guide Operation
Operation Date: 23/10/2018
Raised flap procedure Cortex Guided Surgery kit Guided implant placement in position: #32, #33, #42, #43 Manual bone straitening & reduction Guided bone milling as a preparation for angulated multi-unit placement Immediate temporization with PMMA bridge All components, including the temporary bridge, were prepared in advance. The prosthetic solution was delivered on a Digital model
4. CAD CAM prosthetic solution - Virtual Design
CASE 3
16
Clinical documentation:
Checking guide fit & stability Fixation pins
Site preparation Implant placement Bone reduction Guided bone mill
CASE 3
17
Multi-unit placement Titanium sleeves placement Passive fit of the prosthesis Final result
CASE 3
18
Clinical Follow-Up including X-ray and dates
Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
Implant 44 Implant 42
Implant 32 Implant 34
CASE 3
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CASE 4 (Dr. Meir Mamraev – Israel)
Diagnostics
Age: 56
Gender: Female
Teeth #46, #47 are missing
General Health: good
Digital files: CBCT scan & Digital impression
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CASE 4 Treatment Plan
1. Prosthetically driven virtual implant planning- 3Shape Implant Studio Safety Zone – apical distance – 2.0 mm
Safety Zone – radical distance – 1.5 mm
Position #46: Ø3.8 / 10mm – Dynamix Conical Position #47: Ø3.8 / 8mm – Dynamix Conical
CBCT SCAN MODEL STL
CASE 4
21
CASE 4 2. Guided Surgery- Cortex Guided Surgery Kit + Cortex Guiding sleeve
Implant placement in positions: #46, #47.
3. Surgical guide
Operation
Operation Date: 20/09/2018 Raised flap procedure/ flapless procedure
Guided surgery for implant placement 46
CASE 4
22
CASE 4
Clinical Follow-Up including X-ray and dates
Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
Implant 46 Implant 47
CASE 4
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CASE 5 (Dr. Meir Mamraev – Israel)
Diagnostics
Age: 70
Gender: Female
Fully edentulous upper case
Removable denture
General Health: good
Digital files: dual scan technique
24
CASE 5 Treatment Plan
1. Prosthetically driven virtual implant planning- 3Shape Implant Studio Safety Zone – apical distance – 2.0 mm
Safety Zone – radical distance – 1.5 mm
Position #12: Ø3.8 / 13mm – Dynamix Conical Position #13: Ø3.8 / 13mm – Dynamix Conical
CBCT of the denture with 3D markers inside
the patients mouth CBCT of the denture with 3D markers
CASE 5
25
Position #22: Ø3.8 / 13mm – Dynamix Conical Position #16: Ø3.8 / 16mm – Dynamix Conical Position #23: Ø3.8 / 13mm – Dynamix Conical Position #26: Ø3.8 / 16mm – Dynamix Conical
CASE 5
26
2. Guided Surgery- Cortex Guided Surgery Kit + Cortex Guiding sleeve
3. Surgical guide with three fixation pins
Operation
Operation Date: 19/12/2018 Flapless procedure
Guided surgery for implant placement in position #16, #13, #12, #22, #23, #26
CASE 5
27
Clinical Follow-Up including X-ray and dates
Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.
CASE 5
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