Casereport TRI Matrix David Reaney (BE)
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DENTAL IMPLANTS<br />
CASE REPORT<br />
DR. DAVID REANEY
Introduction<br />
This patient required the replacement of the missing lower posterior<br />
teeth on both sides of the arch to provide additional posterior support.<br />
His main concern was a functional deficiency with difficulty eating although<br />
secondary to this was an aesthetic issue in that he was concerned<br />
about the appearance of the missing lower teeth.<br />
The patient was anxious about implant treatment and so chose to treat<br />
the right side Q4 in the first instance with the treatment to replace the<br />
missing posterior teeth Q3 deferred until Q4 had been completed.<br />
Dr. <strong>David</strong> <strong>Reaney</strong><br />
Following CBCT scan and analysis of the data, virtual implant planning<br />
was carried using 3Shape software.<br />
Final approval was given for the fabrication of a surgical guide for “guided surgery” to provide implants 47, 46<br />
which would later be used to support a 3 unit bridge 47, 46, 45.<br />
The implants chosen for this case were <strong>TRI</strong> ® -<strong>Matrix</strong> bone level implants and the final restoration was a screw retained<br />
monolithic zirconia bridge with no abutments and no titanium base.<br />
The advantage of the <strong>Matrix</strong> system is the precision fit of zirconia to the implant platform with no intervening<br />
abutment.
Case of the Month<br />
Case Overview<br />
Case for the provision of two <strong>TRI</strong> MA<strong>TRI</strong>X bone level implants to support<br />
a three-unit screw-retained fully monolithic zirconia bridge. 47, 46, 45.<br />
Case of the Month<br />
a<br />
Case three-unit for the screw-retained<br />
of the<br />
provision two <strong>TRI</strong> fully ® MA<strong>TRI</strong>X monolithic<br />
Month<br />
abutment zirconia free restorations bridge. 47, to 46, support 45.<br />
a three-unit screw-retained fully monolithic zirconia bridge. 47, 46, 45.<br />
Pre-op intra-oral scan using the Medit i700<br />
Case for for the provision of of two <strong>TRI</strong> MA<strong>TRI</strong>X bone level implants to to support<br />
a three-unit screw-retained fully monolithic zirconia bridge. 47, 46, 45.<br />
Pre-op intra-oral scan using the Medit i700<br />
Pre-op intra-oral scan using the the Medit i700<br />
Case for the provision of two <strong>TRI</strong> MA<strong>TRI</strong>X bone level implants to support<br />
a three-unit Case for the screw-retained provision of two fully <strong>TRI</strong> monolithic MA<strong>TRI</strong>X zirconia bone level bridge. implants 47, 46, to 45. support<br />
a three-unit screw-retained fully monolithic zirconia bridge. 47, 46, 45.<br />
Pre-op intra-oral scan using the Medit i700<br />
Pre-op intra-oral scan using the Medit i700<br />
Digital wax up<br />
provided in EXO-CAD<br />
with restorations<br />
proposed Q4, Q3 – the<br />
patient only requested<br />
Q4 Digital to be wax restored<br />
up up provided in in EXO<br />
initially – three-unit<br />
Digit<br />
with restorations proposed Q4, Q<br />
bridge design-ed on<br />
the the patient only requested with<br />
Q4 Q4t<br />
implants 47, 46.<br />
restored initially –– three-unit brb<br />
designed on on implants 47, 47, 46. 46.<br />
Digital wax up provided in EXO-CAD<br />
Implant planning on software showing inferior dental nerve mapping and<br />
with<br />
implant Digital<br />
restorations<br />
wax positioning. up provided<br />
proposed<br />
in<br />
Q4,<br />
EXO-CAD<br />
Q3 –<br />
the<br />
with<br />
patient<br />
restorations<br />
only requested<br />
proposed<br />
Q4<br />
Q4,<br />
to be<br />
Q3 –<br />
restored<br />
the patient<br />
initially<br />
only<br />
– three-unit<br />
requested<br />
bridge<br />
Q4 to be<br />
designed<br />
restored<br />
on<br />
initially<br />
implants<br />
– three-unit<br />
47, 46.<br />
bridge<br />
designed on implants 47, 46.<br />
the p<br />
resto<br />
desi<br />
Implant planning on on software<br />
showing inferior dental nerve<br />
mapping and implant positionin<br />
Implant planning on software<br />
showing<br />
Implant<br />
inferior<br />
planning<br />
dental<br />
on software<br />
nerve<br />
mapping<br />
showing<br />
and<br />
inferior<br />
implant<br />
dental<br />
positioning.<br />
nerve<br />
mapping and implant positioning.<br />
Impl<br />
show<br />
map
Case Overview<br />
Fully monolithic zirconia bridge 47,46,45 (pontic 45) – screw-retained on <strong>TRI</strong> ® MA<strong>TRI</strong>X bone level<br />
implants. 47,46.<br />
Final restoration – three-unit bridge screw torqued to 35Ncm and access sealed with PTFE tape and<br />
composite resin.<br />
Click link for Video of implant:<br />
https://youtu.be/MNI2W5FgyjE<br />
DENTIST FEEDBACK<br />
Dr. <strong>David</strong> <strong>Reaney</strong>:<br />
“Both myself and the patient were delighted with the<br />
outcome of this case. I used a conventional impression<br />
but in future cases plan to use my scanner to record the<br />
working arch, opposing arch and the occlusal relationship.<br />
The screw retained monolithic zirconia bridge fitted<br />
perfectly without any adjustment to contact points<br />
or occlusion. I have since used <strong>TRI</strong> ® -<strong>Matrix</strong> tissue level<br />
implants for other cases and would certainly consider<br />
tissue level <strong>Matrix</strong> implants when placing implants to<br />
restore Q3. I see significant advantages in moving the<br />
interface between implant platform and the restoration<br />
away from bone level and because there is no<br />
abutment with <strong>Matrix</strong>, cases where space is reduced<br />
can be managed more readily.”
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