2-visit tooth replacement Protocol with PET, immediate implant, 100% CADCAM. Part 1.

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

This video features the surgical phase of 2-visit replacement protocol.
The final FCZ restoration was fabricated digitally, utilizing RRR - Reversed Restorative Rehabilitation Technique.
There is a similar video with the same type of treatment for an upper molar , combined with a sinus lift
https://youtu.be/rqk0v3c_J2o


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9 Comments

Anton. BRAVO! This should work out great for both you and your patient. IMO this approach stilln can be further refined and simplied with the use of platform switch and immediate placement ( or within 10 days) of a contoured abutment or crown out of occlusion. Thank you for sharing. Best regards. Chuck


Reply

Charles, Thank you for the compliment
I have the same thoughts about platform switching. But In this case its not an issue since the implant is 4.2X13mm legacy by Implantdirect has "platform switch" as they claim :). The Zirconia abutment is measured 4.2 mm at the ti-base which also has a bevel. I had seen a good ST and HT stability in these cases.


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Anton,
everything quite nice...but one important piece is missing IMHO, and that is the anticipated alveola study and a pre-operative abutment:
2 main advantages:
- a 'one time healing concept'
-a 'one abutment one time' concept
Refer to:
http://www.dentalxp.com/video/socket-shield-image-guided-1152473.aspx
Implant studio may now contain the technology to do that.
The PET is a key factor, on my opinion, as provides predictable result in terms of hard and soft tissue healing pattern.
Wait to see part two.
Regards.
Armando


Reply

Armando, thank you for compliments. Surgical planning with CBCT, is always a good thing to start with. For this particular case I have not used it. There was slight deviation of the implant axis towards the canine apocally. I was able to compensate it utilizing 3Shape Dental Designer which allows to change the angulation of the aaccess hole .
As for Implant Studio, I had used it on bigger cases. It has some flaws and limitations so I am waiting for 2015 version to be released in the US to see if 3Shape was able to fix them.


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Great procedure Anton,

Beautifully managed. I have never placed the bone graft before placing the implant. Wouldn't this affect in the threading of the implant into the bone, and cause the implant not to seat properly?

Also, you would prefer to have as much as natural bone in contact with the implant instead of the grafting material?

Thanks


Reply

Thank you Adoni,
I placed BG before the implant because the direction of the osseotomy was changed to be more mesially compared to the socket which was distally positioned towards the molar. The gap would be too small to squeeze any BG after implant is placed so I had to do it first.


Reply

Anton; Thanks for sharing...Dr. Salama


Reply

Thank you for the opportunity, Maurice!


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there is another video for the same technique but also with a sinus lift.
https://youtu.be/rqk0v3c_J2o


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