CAD0111

12 I I case report _ guided implantation prepared using the Straumann Guided Surgery Kit, in accordance with the surgical protocol supplied by SICAT (Figs. 13 & 14). Figures 15 and 16showtheimplantbedimmediatelyafterplace- ment with and without healing cap, respectively. During the ten-week healing period, the neigh- bouring teeth were supplied with chairside-fab- ricated CEREC inlays (Fig. 17). The final prosthetic is created using a conventional impression since intra-oral scanning of implants—although tech- nologicallypossible—hasnotyetbeenreleasedby the manufacturer (Sirona). _Discussion Planning of the implant position based on scan data of the clinical situation was already described a few years ago. However, the data in questionwasgatheredfromextra-oraldigitalised stone models.3 What is really interesting now for dentist and patient alike is the merging of data generated from an intra-oral scan with CT- or CBCT-gener- ated DICOM data, as in the case presented. This provides a number of advantages: it eliminates the need for conventional impressions, the fabri- cation of stone models and elaborate fabrication of conventional radiographic templates by a dental technician. This means not only greater patient comfort but also a reduction in the num- ber of patient visits. In addition, guided implantology has addi- tional advantages, such as greater safety; a more predictable aesthetic outcome; a minimally inva- sive procedure through flapless surgery, which in turn means less pain; and a reduction in down- time for the patient. A sharp outline and much more precise imaging of the gingival margin via the imported intra-oral scan also helps to make a better assessment of the emergence profile of the implant during the planning phase. Presently, a physical model is still required to fabricateasurgicalguidefornavigatedimplanta- tion, currently mostly made using a conventional impression. Instead, the present case used an SLA model fabricated from the intra-oral digital im- pression, in order to be able to work entirely with- out conventional impressions. Preferable for cli- nicians would be a fabrication of surgical guides without the need for a physical model. According to the manufacturer (SICAT), further develop- ments in this direction are already underway and will be introduced at the IDS 2011. In summary, it can be said that guided implan- tology for specific indications is already possible today without any conventional impression by combining intra-oral scans, CBCT and an SLA model._ Editorial note: A list of references is available from the publisher. Fig. 12_Quality control: measurement of sleeve position. Fig. 13_Surgical guide after tissue punch in situ. Fig. 14_Preparation of implant bed. Fig. 15_Implant in situ without healing cap/gingival former. The punch-out hole appears oval as a result of distortion by the mirror. Fig. 16_Implant with gingival former immediately post-op. Fig. 17_Situation after ten-week healing period and inclusion of CEREC chairside inlays at teeth #35 and 37. CAD/CAM 1_2011 Dr Jan-Frederik Güth Poliklinik für Zahnärztliche Prothetik, LMU München Goethestraße 70 80336 München Germany jan_frederik.gueth@med.uni-muenchen.de CAD/CAM_contact Fig. 15 Fig. 12 Fig. 13 Fig. 14 Fig. 16 Fig. 17