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36 I I industry report _ navigated implant placement it was feasible to implement the screw retentions exactly according to plan such that no adverse aesthetic effects arose. The far-reaching bridge was fabricated at the Nobel Biocare milling centre and was prepared for the veneering steps with only little time required for minor details of post-production processing. Thanks to CAD/CAM technology, it is possible to generate frameworks that are truly free of tension. In this context, Nobel Biocare guarantees a precision of fit of less than 25 µm. For aesthetic reasons, an elaborate form of re- storationwasselectedfortheupperjaw.AProcera ImplantBridgeTitaniumonmulti-unitabutments was produced. The bridge was designed to allow all-ceramic NobelProcera Crowns Alumina to be cemented to them. For this purpose, the frame- work was veneered with a gingiva-coloured ce- ramic material and opaquer was attached in the region of the stumps by firing (Figs. 21 & 22). In the next step, the single crowns were prepared (Fig. 23). After completion of the entire restora- tion, the basic framework was screw-retained in the mouth (Fig. 24) and the aesthetic Procera alu- mina single crowns were cemented in the mouth using conventional cement (Durelon, 3M ESPE; Fig.25).Accordingly,thepatient’srestorationwas still conditionally removable in the dental office, since the crowns covering the screw channels remained removable. This is advantageous for thepatientinthattheaestheticappearanceofthe upper jaw can be improved even further, while no screw channels are visible. This resulted in an excellent aesthetic appearance at the red–white transition (Figs. 26 & 27). _Conclusion In this article we have demonstrated a dental teambeingabletooffertreatmentbasedonaone- provider concept that starts with a 3-D diagnostic work-up, allows for template-guided navigated implant placement, keeps in stock all implant and prosthetic components (as typifies the concept of Nobel Biocare), and offers numerous advantages, including: _application of a broad range of different tech- niques from a single supplier; _only a single supplier needs to be contacted; _implant and prosthetic components match; _interfaces match; _materials match; _final result has a high precision of fit; _generous solutions if difficulties are encoun- tered; and _custom-made designs for special needs. Approaching the planning and implementation ofanimplant-bornerestorationfromthepatient’s perspective and his or her needs will always cause the treatment team to place safety very high up on the list of its priorities. Based on the reliable NobelGuide concept, the success of the team be- comes a matter of planning. To have but a single supplier to contact for all necessary components saves time and the attending team can rely on the perfect match of all components. Another aspect that should not be underestimated is the increas- ing number of litigations after unsuccessful out- comes. Products that have been tested in numer- ous scientific studies provide the needed validity. 3-D planned and template-guided implant place- ment, aesthetically pleasing forms of restoration, and a long service life of the restorations also appeal to the patients. The dental office of Drs Grebe periodically or- ganises courses in 3-D implantology and CAD/CAM prosthetics for dentists and dental technicians. If you are interested, please enquire about the dates of upcoming events by e-mail. We would like to thank our dental technicians MichaelaSchenker,FrankRödelandJörgParsaksen for their support._ Editorial note: A list of references is available from the authors. Fig. 27_Panoramic X-ray. CAD/CAM 1_2011 Dr Götz Grebe & Dr Melanie Grebe Schwanenwall 10 44135 Dortmund Germany praxis@dr-grebe.de www.dr-grebe.de CAD/CAM_contact Fig. 27