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Case Reports
. 2017 Apr 10;10(1):71-77.
doi: 10.11138/orl/2017.10.1.071. eCollection 2017 Jan-Mar.

Postextraction computer-guided implant surgery in partially edentate patients with metal restorations: a case report

A Pinto  1 , C Raffone  1
Affiliations
Case Reports

Postextraction computer-guided implant surgery in partially edentate patients with metal restorations: a case report

A Pinto et al. Oral Implantol (Rome). .

Abstract

Objectives: The aim of the present study was to describe a postextraction, computer-guided protocol for implant-prosthetic rehabilitations in partially edentate patients with metal restorations.

Methods: A 60-year-old man with a loose FDP (fixed dental prosthesis) in the first quadrant was selected for a postextraction computer guided implantology according with the 2-piece radiographic template protocol. A two components radiographic template was produced, with the teeth setup portion based on the wax-up. CBCT (cone beam computed tomography) scans of the patient, wearing the base portion of the radiographic template and of the assembled radiographic template alone, were accomplished. The CBCT volume were imported in a dedicated software (NobelClinician, Nobel-Biocare, Kloten, Switzerland) and a surgical template was produced from the digital planning. The surgery was performed with a flap approach, as a bone regeneration procedure was carried out. A delayed loading protocol was chosen to allow a healing free of masticatory stress. A mobile partial denture was delivered to the patient to grant function and social life until the delivery of the definitive FDP.

Results: The surgery was performed rapidly and free of obstacles. A good primary stability of the implants was achieved. The patient referred an acceptable postoperative pain and swelling.

Conclusions: The 2-piece radiographic template protocol was evaluated as smooth, complication-free and suitable for patients who want to maintain their teeth until the day of implant surgery. A good command of the computer-guided software as well as a comprehensive learning curve in computer-guided implantology is necessary to obtain predictable results.

Keywords: 2-piece radiographic template; computer-guided implant surgery; dental implant; double scan; postextraction implant.

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Figures

Figure 1
Figure 1
Buccal, occlusal and palatal preoperative view.
Figure 2
Figure 2
Pre-operative CBCT panorex slice.
Figure 3
Figure 3
Radiographic template with teeth setup portion in place and out of place.
Figure 4
Figure 4
Digital implant planning. Frontal slice and 3D volume rendering.
Figure 5
Figure 5
Surgical template.
Figure 6
Figure 6
The FDP portion atraumatically extracted.
Figure 7
Figure 7
Intraoperative steps.
Figure 8
Figure 8
Post-operative intraoral X-ray.
See this image and copyright information in PMC

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