Clinical dentistry by Richard L. Seberg, DDS
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IntroductionDigital treatment planning and a SurgiGuide from Materialise were used to place the implant using a combination of drills and osteotomes. A healing abutment was threaded into the implant and the patient's existing BioTemps bridge was recemented to provisionalize the case. For this case, the implant was not provisionalized. Instead, the patient's existing temporary bridge was utilized. One major advantage of this technique is that the implant is well protected during the healing period. Another option would have been to fabricate three individual provisional crowns – one for each of the prepped teeth and one for the implant. Because it was already made, we went with the bridge.Figure #1Evaluating the soft tissue and ridge after the BioTemps bridge has been removed. -
Figure #2The case was planned utilizing the SimPlant software. A SurgiGuide, based on the digital plan, is used to guide the 2.0 mm pilot drill in a flapless procedure. -
Figure #3A tissue punch is used to incise the soft tissue. This was possible in this case as there was adequate attached tissue. -
Figure #4The soft tissue plug is removed. -
Figure #5An osteotome is used to help expand the ridge. -
Figure #6The 3.5 mm Tapered Drill is used through the next SurgiGuide. -
Figure #7The oseotomy is completed with a series of osteotomes. -
Figure #8The NobelReplace WP Implant is threaded into the osteotomy. -
Figure #9Final seating of the implant is done by hand with the torque wrench. -
Figure #10An implant level impression was made. This shows the impression of the natural preps and the implant impression coping that has been "picked up." -
Figure #11A healing abutment is threaded into the implant. -
Figure #12The top of the healing abutment should be slightly above the soft tissue crest. -
Figure #13The underside of the pontic is adjusted so that it does not seat on the healing abutment. -
Figure #14The BioTemp bridge is cemented back into place. All excess cement must be removed. -
Figure #15The occlusion is checked and the patient is given post-operative instructions.
