Download - Clinical Case: Gordon-E
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Copyright © 2011 Idondivi, Inc. All rights reserved.
Prototype : same concept different look
Categories : Posterior, grafting, multiple implants, prototype, Nobel
Biocare
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Failing 3 unit bridge abutment tooth # 29
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Cast is cut at proposed implant axis
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Implant angle based on prosthetic outcome. More buccal on site were premolar is
to be extracted, anticipating buccal boneloss.
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Prototype BLP glued into place. Determining bucco-lingual position and the top of
the implant
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Prototype BLP’s positioned for side by side implants
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Surgical guide in place while tooth # 29 and pontic # 30 have not yet been
removed.
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X-ray not shot perpendicular. Double view of RIR’s.
Current RIR’s are fully radio- opaque , while prototypes only on the outlines
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X-ray shot correctly, overlap RIR.
7 degree rotation block indicated to engage some native bone on the mesial , so
on purpose not following the existing alveolus
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Guided surgery does not mean flapless surgery
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Foramen relative to tooth apex as visualized on PA radiograph
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Very precise depth control is needed as we are close to the foramen , Drill set at
7 mm
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Very precise depth control is needed as we are close to the foramen , Drill set at
10 mm. Still short from the apex. In this way we are always safely away from the
foramen.
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Implant placement and bone augmentation
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Green line bottom of the implant
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Green line bottom of the implant
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Actual distance between implant tip and foramen 2.9 mm, while on 2 dimensial
PA radiograph it would appear to be 1.4 mm
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Non resorbable membrane protect bone augmentation and will develop abundant
keratinized gingiva.
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8 weeks post placement
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Restored with two single crowns