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From Intraoral Scan to Final Custom Implant Restoration Go online for in-depth content by Perry E. Jones, DDS, FAGD Introduction This case demonstrates the optical scanning of <strong>Glidewell</strong> Laboratories’ purpose-made Inclusive ® Scanning Abutments utilizing the iTero digital scanning system (Align Technology; San Jose, Calif.) with software version 4.0. Digital data was used in conjunction with laboratory CAD/CAM planning to fabricate custom all-ceramic implant abutments and a final 4-unit fixed prosthesis. The abutments and fixed prosthesis were fabricated using advanced computer-aided milling technology. Editor’s note: Cadent Inc. (Carlstadt, N.J.) was acquired by Align Technology (San Jose, Calif.) in May 2011. 6 – www.inclusivemagazine.com –
<strong>Dental</strong> History The patient in this case was a 52-year-old healthy Hispanic male who sustained a traumatic avulsion and loss of his maxillary incisors in an automobile accident. Following healing, the patient reported that a 4-tooth transitional removable partial denture was constructed. He was seen by the oral and maxillofacial surgery service of Virginia Commonwealth University, as he desired dental implant therapy. The patient reported multiple incidents of a “broken” provisional denture (Fig. 1). Treatment Plan The patient was informed of the alternatives, benefits and potential complications of various treatment options before confirming his desire to pursue implant restoration of his missing anterior teeth. The treatment plan included placement of two Replace ® Select Straight RP 4.3 x 13 mm implants (Nobel Biocare; Yorba Linda, Calif.) with 5 mm healing abutments, followed by a six-month healing period and restoration with all-zirconia custom abutments and a 4-unit all-ceramic fixed prosthesis to restore the anterior incisors to form and function. Surgical Procedure Using local anesthesia, two Replace Select Straight RP implant fixtures were placed in the area of tooth #7 and #10 using standard Nobel Biocare implant placement protocol. Placement angulation and depth were verified and appeared to be satisfactory (Fig. 2). Standard RP 5 mm healing abutments were placed, and the fully reflected tissue flap was closed with interrupted sutures (Fig. 3). Figure 1: Patient presents with broken RPD. Note tight anterior coupling. Figure 2: Osteotomies for implants #7 and #10 with guide pins The patient was informed of the alternatives, benefits and potential complications of various treatment options before confirming his desire to pursue implant restoration of his missing anterior teeth. Figure 3: Post placement with 5 mm healing abutments and sutures – From Intraoral Scan to Final Custom Implant Restoration – 7
Page 1 and 2: Inclusive® Restorative Driven Impl
Page 3: Contents 6 15 From Intraoral Scan t
Page 6 and 7: Contributors ■ Bradley C. Bockhor
Page 10 and 11: Figure 4: Healing abutments at six
Page 12 and 13: Figure 15: iTero virtual scan (Alig
Page 14 and 15: Figure 25: 4-unit BruxZir Solid Zir
Page 17 and 18: Implant Q&A: An Interview with Dr.
Page 19 and 20: Not only are we maintaining the bon
Page 21: BB: If you go that route — four i
Page 24 and 25: For proper prosthetic function, zir
Page 26 and 27: On the abutment, there were three a
Page 28: Finite element analysis (FEA) provi
Page 31 and 32: Figure 1: Graph depicting usage of
Page 33 and 34: Clinical Delivery The following pro
Page 35: Delivery of a Screw-Retained BruxZi
Page 39 and 40: Figure 1: Preoperative digital trea
Page 41 and 42: Figure 8: Inclusive Mini Implant Im
Page 43 and 44: Figure 16: Wax rim delivered on cas
Page 45 and 46: Figure 26: Articulated model with b
Page 47 and 48: Implant-retained overdentures can o
Page 49 and 50: Figure 2: Sagittal MPR view with ma
Page 52 and 53: Understanding Zirconia Crown Esthet
Page 54 and 55: Spectrophotometry A spectrophotomet
Page 56 and 57: The key to increasing light transmi
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Inclusive ® Image Contest: Name Th
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