Implant Placement and Immediate Final Rehabilitation

EDI Case Studies 3 For three-dimensional planning based on CT scan- ning, the reference points of the clinical situation need to be precisely transferred to the planning template. Experience has shown that mucosa-sup- ported surgical stents are inadequate for this pur- pose. This can be overcome by using temporary implants or reference points on natural teeth for fix- ation and reference. These reference points can be used to position the diagnostic stent back precisely on the master cast. After the chosen positions for the implants have been determined using the stan- dard rules of backward planning, drilling sleeves are secured precisely onto the template. This allows pre- cise placement of the implant analogs into the mas- ter cast in terms of position, depth and axial orienta- tion. The technician can only fabricate a precisely fit- ting final rehabilitation prior to implant placement if the master cast accurately reflects the implant position that will be achieved. The same stent can then be used during the surgical procedure, enabling implants to be inserted in the mouth exactly as planned on the master cast. Precise trans- fer is ensured, as the initial reference points are used again. Essential requirements for this purpose include high-precision accessories which are includ- ed with the Camlog Guide system and exact adjust- ment of all equipment during positioning of the guide sleeves. Implant Placement and Immediate Final Rehabilitation Axel Kirsch, DDS, DMD, Rainer Nagel, DDS, Dentist, Gerhard Neuendorff, MDT, Janez Fiderschek, MDT, and Karl-Ludwig Ackermann, DDS, DMD, all Filderstadt/Germany New technology allows for the placement of dental implants and the final rehabilitation at the same visit. This requires precise three-dimensional radiographics, exact reproduction of the clinical situation in the dental laboratory, construction of a surgical stent which rigidly controls implant placement and fabrication of the final rehabilitation. Extensive collaboration of the clinical, diagnostic and laboratory teams are required. A case presenting with an edentulous mandible is used to illustrate the protocol. Using the Camlog Guide technology the final rehabilitation is placed immediately following implant placement. CT based three- dimensional planning giving rise to stent-guided implant placement and immediate delivery of a final rehabilitation