Simultaneous CAD-CAM MODEL-LESS Posterior Rehabilitation with Dental Implants in all four quadrants. Part 2.

206 Rating(s).


Posted on By Anton Andrews In Implants

55 y.o. healthy male presented with loss of posterior teeth in all 4 quadrants, collapsed bite with moderate TMJ arthrosis etc.

SINGLE surgery - 7 implants placed along with few extractions, bi-lateral crestal sinus lifts, GBRs.Russian AAA style. No surgical guides had been used.

Restored 100% digitally without any models with Andrews RRR ,CAD-CAM all screw-retained full contour zirconia.
#19 IMPLANT RESTORED WITH DOUBLE M-D CANTILEVER.It is 17-18mm wide M-D!

VDO had been opened with Gneuromuscular technique.
Occlusion was tuned 2 weeks after delivery with TENS.
Comments, discussion??

All implants were placed without surgical guides

dental-continuing-education.com
Crossection of the lower crown, 17mm wide M-D


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13 Comments

Utilization of the wide 5.7 mm Zimmer platform on 8X9 mm implant allowed to restore with over-sized screw-retained crown on #18-19 area measured >17mm M-D.


Reply

Anyhony,
Remarkable digital work. Well done. I wonder about the emergence profile of your 'monster tooth'':the digital photo shown may require some clinical adjustment for proper fitting.
Thanks for sharing.
Armando


Reply

Armando, thank you for the comment.
To comprehend what was done digitally on a case of such scale, someone has to have CAD experience , like you do.
All scanning for implants positions was done simultaneously during UNCOVERY appointment. Emergence profile on all restorations was designed to shape the soft tissue into ideal contours with Final Restorations.
This is the core of my RRR concept .
Nowadays I scan at the time of the implant placement and deliver final restorations on UNCOVERY-1T1A.


Reply

Andrew, talking about data, in the picture #4 you show some very deep contact on marginal gingiva, that may not allow an immediate prosthetic fit, unless you modify gingival spaces or prosthetic emergence profile. Unfortunately the clinical picture is not on focus on the area: can you send some to see the adaptation of the crown? It is of interest to me what you are doing as, I believe that it will be the future way of doing dentistry. It is therefore a great opportunity to discuss your cases. Armando


Reply

For me its the reality, for others might be probably the future.
these images were taken 2 weeks post insertion. Soft tissue is still not formed completely.
I'll post the follow-ups later

2 weeks post insertion


Reply

Anton I will soon shift to digital world. Which is your scanner?
And your program that you use?
Thanks, Jorge


Reply

To scan - Trios 3 from 3shape should be available in Europe already. It also has shade recognition and intraoral camera functions.
To design you'll need loaded Dental System 3Shape with implant module.
And I forgot to mention that for the clinic of your size you also want milling and sintering on site.
With the glazing it will be full cycle in-house.


Reply

Thanks Anton!
I´ll move to digital soon, I think. (Youre cases make me more confident) Thanks for posting.
Jorge


Reply

You will blame yourself for waiting too long..


Reply

Anton. Nice work! The larger prosthesis is functional. Not only avoids food impaction, but helps dissipate forces. Please continue to update. Thank you for sharing. Best regards. Chuck


Reply

Thank you Charles,
I see that now you agree that for large prosthetics we need good foundation:)


Reply

Good information,and i like this.


Reply

1-year follow up.

Reversed restorative rehabilitation | RRR


Reply

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