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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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