Tom sealey Dentsply Case Study -SIMPLANT (5) (1) · temporary crown was chosen to achieve immediate...
Transcript of Tom sealey Dentsply Case Study -SIMPLANT (5) (1) · temporary crown was chosen to achieve immediate...
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SIMPLANT® computer guidedimplant treatment with theASTRA TECH Implant System™EV with Immediate Smile®
featuring ATLANTIS™ Abutment
A 65 year old male presented with a failingconventional cantilever bridge replacing tooth12. The abutment tooth 13 had previously beentreated with apical surgery and had dentalcaries compromising the margins of the post-retained crown. The patient requested animmediate smile solution if possible. Theclinical situation presented itself suitable for anImmediate Smile featuring ATLANTIS Abutmentutilising the SIMPLANT Safe guide andsoftware from Dentsply Sirona. An ASTRATECH OsseoSpeed EV implant in combinationwith ATLANTIS abutment and CAD-CAMtemporary crown was chosen to achieveimmediate replacement and excellentaesthetics.
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Case ReportDr Thomas Sealey
BChD, MMedEd, DipEndoBest Young Dentist South-East 2015
Start-Smiling Dental PracticeIngatestone
EssexCM4 0BY
[email protected]@StartSmiling1
@ThomasSealey1
1. Pre-operative radiograph
An upper digital periapical radiograph showingcaries under the mesial margin of the crownabutment on a conventional cantilever bridgereplacing missing tooth 12.
2. Initial clinical situation
After bridge removal , showing compromised post-core with caries on tooth 13. Unsuitable to act as anabutment to support a new bridge. This tooth will berestored separately.
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3. Bridge removal and temporisation of tooth 13
The bridge was removed and a temporary acryliccrown made for tooth 13. A CBCT scan was takento assess the area for suitability for implantplacement.
4. Scan Impression/plaster model
A plaster model of the teeth was scanned using3Shape Dental SystemsTM software and exportedinto SIMPLANT digital solutions and ATLANTIS 3DEditor.
5. Implant design
The implant size and position was chosen using theintegrated implant catalogue within the SIMPLANTsoftware.
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6. Temporary Crown design
ATLANTIS designed the abutment and the core filewas sent to the dental laboratory for the CAD-CAMcrown design and manufacture.
7. Crown and Abutment
Received and tried against the teeth pre-surgery tocheck colour and general shape.
8. SIMPLANT SAFE guide try-in
SAFE guide was tried in to ensure accurate andsecure fit. The chosen surgical guide was of toothand mucosa-bourne support and is a full positionand depth guided solution.
9. Flap raised
Procedure may have been completed using aflapless technique but being the first time thissystem had been used in the UK it was decided toraise a small flap to improve vision and access forimplant placement.
10. Guided drilling
SIMPLANT SAFE surgical guided drilling ensuresboth correct alignment and depth of the osteotomy.Note the white stop on the drill which ensures thatdrilling does not exceed the correct depth.
11. Implant locator radiograph
Taken to ensure correct position and angulationsafter first drill. SAFE guide was replaced forsequential drill sequence at 1500rpm with abundantsaline irrigation.
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12. Osteotomy depth gauge
Osteotomy is measured to ensure correct depthreached . This was for illustration only and can beomitted once you are an experienced user.
13. Implant placement
Implant driver used at low speed of 25rpm andmaximum torque of 45N with ample saline irrigation.Placed slowly until notches on driver and SAFEguide are aligned. This ensures correct positioningfor ATLANTIS abutment.
14. Final implant positioning radiograph
Correct depth and positioning of Osseospeed EV4.2S x 13mm implant. Good initial stability of over35N torque.
15. ATLANTIS abutment placement
Placed to temporary restoration torque of 15N. Thescrew access is sealed with warm condensed guttapercha. Two 4.0 monofilament sutures are placed.
16. Temporary crown
Cemented with Non-Eugenol temporary cement.Occlusion checked to ensure no contact with otherteeth. Sutures to be removed after 7 days withhealing by primary intention.
17. Final radiograph
Good location of abutment to implant. Sometemporary cement visible at mesial margin oftemporary crown which was removed afterradiograph exposure.
www.dentsply.com/en-uk/implants
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