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I 31 industry report _ navigated implant placement I CAD/CAM 1_2011 The NobelGuide team always includes the den- tal technician, the prosthetic expert, the surgeon, the patient, and, if applicable, the radiologist recording the 3-D images. The advantages of in- tegrating 3-D diagnostics, 3-D planning and 3-D templates outweigh the disadvantages, such as increasedradiationexposureandassociatedcosts, which are the ones most mentioned. The definite advantages of this approach in- clude certainty of diagnosis, precise surgical im- plementation, avoidance of angular deviations at depth during the surgery, expansion of the range of indications, and prevention of clinical and pros- theticcomplicationstoalargedegree,especiallyin the application of NobelActive implants, as is de- scribedbelow.TheNobelActiveimplantsystemwas developed for experienced surgeons in order to be able to attain high primary stability even in com- promised bone and under difficult conditions. Two new tools—NobelClinician and Nobel- Connect—enable even better networking between the participating team partners for collaborative purposes by granting each partner access to the currentstateofthecase—from3-Dplanningtothe insertion of the implant restoration—through a dedicated software interface. This facilitates com- munication, especially if team mem- bers do not work in the same locale. Aftertakingthehistoryandarriving at a clinical diagnosis, the 3-D analysis is performed and the results are dis- cussed to determine the treatment plan. NobelGuide, being both a surgi- cal and a prosthetic system, is advan- tageous in that it allows a temporary restoration to be fabricated by the dental laboratory prior to surgical intervention, provided this is needed and indicated. The labo- ratory can utilise the drilling template made in a centralised industrial production facility to trans- fer the planned implant positions to a model such that the temporary restoration can be fabricated without the risk of transfer losses. _Case I: Lateral tooth restoration The first case presented concerns a 75-year- old female patient and documents a situation that is commonly encountered. The plan was to treat tooth #14 with a single crown and place a bridge on two implants. Furthermore, teeth #23 and 24 wereeachtoreceivesinglecrownsand,inaddition, an implant bridge on three implants was planned (Figs. 4a–f). In this case, what made the use of NobelGuide so attractive for patient, dental tech- nician and surgeon? Easierhandling Owingtotheexact3-DdesignwithNobelGuide, the surgeon was able to proceed despite the reduced amount of available bone. A sinus lift was not necessary. It was possible to place all five implants without having to generate a flap, mini- Fig. 5_The impression for preparation of the master model over teeth and implants was taken in the same surgical session. Figs. 6 & 7_Procera Crowns Alumina and Procera Implant Bridges with screw retention at implant level. Fig. 8_Screw-retained abutment and bridge are made of the same material. Fig. 9_Very high quality milled titanium material and no gingival irritation is caused by a cement gap, since there is no such gap. Fig. 10_Optimal aesthetics and integration of restoration. Fig. 11_Disastrous clinical situation. Fig. 12_Teeth could not be conserved and had to be removed. Fig. 10Fig. 9Fig. 8 Fig. 12Fig. 11 Fig. 7Fig. 6Fig. 5