3-visit digital Posterior rehab with wide implants and sinus lift.Cantilevered implant bridges. RRR. 1-year follow up

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Posted on By Anton Andrews In Digital Scanning & CAD/CAM

Reversed Restorative Rehabilitation had been used to restore missing left molars.
Wide implants - 7X10 with cantilevered FCZ CAD/CAM model-les screw-retained bridges.
Sinus lift upper, GBR lower.
Only 3 appointments
1. Surgery
2. Scanning
3. Delivery
Now the same result could be achieved in only 2 appointments with 2-visit tooth replacement protocol.
Thoughts, comments,questions

Reversed Restorative Rehabilitation by Dr. Andrews
Model-less CAD/CAM fabrication. Lab cost for the entire case, including implant parts is ONLY $372.20

RRR | DENTOLOGY CE
2-weeks post op demonstrates excellent healing, absence of black triangles, functional occlusion
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16 Comments

Excellent Anton! How did you lift the sinus and place an implant in the same appt?

How long do you then wait to scan and restore?

7x10mm are super implants. They can cantilever anything.


Reply

Hi Peter,
If you follow this link you'll see how to extract a tooth with PET, lift a sinus and place an implant in one visit. These days I also sca. After the implant is placed, thus the while txt is only 2-visits.
http://youtu.be/rqk0v3c_J2o


Reply

Hi Anton , great case.


I have just started to use the titanium interfases + monolithic zirconium crowns.

I find the tolerance between the two parts to be too big, when I fit the crown over the interface it rotates quite a bit.

I am cementing the crowns intraorally, to afterwards unscrew it to remove cement excess, and minimize positioning errors like this.

Do you find this problem as well ?

Thanks for sharing


Reply

Thx Andoni
Regarding tolerances, it depends on milling settings and quality of the milling center equipment.
I woke with 3DBioCAD and they able to deliver precise restorations which I ALWAYS assemble extraorally and deliver in screw-retained fashion


Reply

Hi Anton. So far so good. Did you address this patients other side? A wide diameter implant / distal cantelever opportunity? Thank you for sharing. Best regards. Chuck.


Reply

Chuck, for another side and the distal cantilever, I'll refer this patient to you :)


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Do you have occlusal contact on the cantilever teeth? The occlusal tables do not appear to be narrowed. How do you control the off axial loading of the implants?


Reply

Hi Anton;
I am always nervous about cantilevers. Might it not have been prudent to place 4 implants (2 max, 2 mand) given the poor quality of the maxillary posterior bone?

A second concern are all of the teeth with periodical areas, # 3,11 and 23. (Max right first molar, Max left cuspid and lower left lateral incisor.)

Just wondering.
Thanks,
gerald


Reply

Anton,

my question same as Gerald- why cantilever?

and did you modify your occlusal interface?

Cheers,

Richard


Reply

http://forum.dentalxp.com/case/details/100-digital-cadcam-cantilever-bridge-on/3508


Reply

2-year follow-up for another cantilever case.
All teeth are in occlusion, no narrow occlusal tables.
7mm wide implant, 5.7mm platform with 3mm internal hex can tolerate cantilever. 4 mm implant will not

2-year follow up
2-year follow up


Reply

Anton In the radiograph, on the mesial aspect of the implant, suggests there is loss of intergration of the 4 coronal threads? Did you probe the implant on your 2 year follow-up?


Reply

This is a pan, in no way can you diagnose bone loss . In any case you're seeing the overlap of buccal and lingual plate superimpositions. What would probing tell you anyways if you lost 2-4 threads? Nothing , in fact you'll break the attachment of tissue around abutment .


Reply

There is no loss Richard. Refer to the original post you'll see that the bone is the same. I'll take CBCT soon , we have the same kind of tx on another side.


Reply

Anton,

I never asked about bone loss-I think that was Jerome

Cheers,

Richard


Reply

1-year update


Reply

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