implants - international magazine of oral implantology

clinical technique _ troubleshooting I I 31implants2_2011 Figs. 31–33_Three-dimensional diagnosis and planning (see dental pins) of the third and fourth quadrant. Fig. 34_Orthopantomogram after incorporation of four implants, three of which were diameter-reduced Roxolid (Straumann) implants. neither in the extended front-tooth area nor in the side-tooth area owing to the narrow and at- rophied alveolar ridge. Our solution It was true that the alveolar ridge on both sides, starting with the cuspid region and ex- tending to the area where the molars had been previously, was fairly pointed, and the course of the osseous limbus alveolaris displayed a pro- nounced sagging distally of the previous pre- molar zone. The patient thus showed considerable osseous deficits in both the oro-vestibular and horizontal dimension. In order to assess the basic possibili- ties of oral implants, we decided to perform 3-D imaging, which proved extremely helpful in this complex patient case. After illustration of the os- seous situation, there were indications that im- plantation would be possible without carrying out augmentation procedures. We then prepared a virtual implant plan, the results of which led us to prepare a drilling template. The remaining front teeth proved very helpful as a place for securely anchoring the template. By opting for a shortened row of teeth with one im- plant each in the region of the former six-year molars and an additional artificial abutment in each of the former cuspid areas, we were able to keep the dimensions of the template relatively small. The insertion of four implants in the regions of teeth #46, 43, 33 and 36 and their osseointegra- tion were followed by treatment with the supra- structures, which consisted of two bridges in re- gions #46 to 43 and 33 to 36, entirely supported by implants, and four individual crowns on the front teeth. The restorations were temporarily af- fixedforsixmonthsandthencementedinplace._ Fig. 32 Fig. 33 Dr Georg Bach Oral surgery specialist Rathausgasse 36 79098 Freiburg/Breisgau,Germany doc.bach@t-online.de ZTM Christian Müller Master dental technician DentalTechnik Müller Carl-Kistner-Straße 21 79115 Freiburg/Breisgau,Germany CHMUE10@aol.com _contact implants Fig. 31 Fig. 34