Abstract
BackgroundComputer-assisted implant planning has become an important diagnostic and therapeutic tool in modern dentistry. This case report emphasizes the possibilities in modern implantology combining virtual implant planning, guided surgery with tooth and implant supported templates, immediate implant placement and loading.Case presentationA straight forward approach was followed for the mandible presenting with hopeless lower incisors. Diagnosis, decision making and treatment approach were based on clinical findings and detailed virtual three-dimensional implant planning. Extractions of the hopeless mandibular incisors, immediate and guided implant placement of six standard implants, and immediate loading with a provisional fixed dental prosthesis (FDP) were performed fulfilling patient’s functional and esthetic demands. The final computer assisted design / computer assisted manufacturing (CAD/CAM) FDP with a titanium framework and composite veneering was delivered after 6 months. At the 1-year recall the FDP was free of technical complications. Stable bony conditions and a healthy peri-implant mucosa could be observed.ConclusionsComputer assisted implantology including three-dimensional virtual implant planning, guided surgery, and CAD/CAM fabrication of provisional and final reconstructions allowed for a concise treatment workflow with predictable esthetic and functional outcomes in this mandibular full-arch case. The combination of immediate implant placement and immediate loading was considerably more complex and required a high level of organization between implantologist, technician and patient. After the usage of a first tooth-supported surgical template with subsequent extraction of the supporting teeth, a second surgical template stabilized on the previously inserted implants helped to transfer the planned implant position in the extraction sites with a guided approach.
Highlights
Computer-assisted implant planning has become an important diagnostic and therapeutic tool in modern dentistry
Computer assisted implantology including three-dimensional virtual implant planning, guided surgery, and computer assisted design / computer assisted manufacturing (CAD/CAM) fabrication of provisional and final reconstructions allowed for a concise treatment workflow with predictable esthetic and functional outcomes in this mandibular full-arch case
Based on a computerized tomography (CT) scan and a digitized tooth setup, the prosthetically ideal implant positions can be planned virtually with the help of a guided surgery software allowing for three dimensional visualization prior to implant surgery [2, 5, 6]
Summary
The present case report emphasized the efficient workflow and the predictable outcome using computer assisted implantology. The fabrication of an immediate provisional FDP and, subsequently, the final CAD/CAM reconstruction was facilitated by CAI fulfilling patient’s wish of being continuously restored during the complete treatment. Abbreviations CAD/CAM: Computer assisted design / computer assisted manufacturing; CAI: Computer assisted implantology; CBCT: Cone beam computed tomography; CT: Computerized tomography; FDI: Fédération Dentaire Internationale; FDP: Fixed dental prosthesis; RPD: Removable partial denture
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