Clinical
dentistry Digital
Dr Jesús López Vilagran describes an anterior double-ocean implant-supported aesthetic restoration using the digital workflow and guided surgery
Patient 63-year-old male.
Clinical history No medical diseases and no relevant history.
Reason for the restoration The patient visited the clinic due to class-2 mobility of teeth 11, 12, 21 and 22 caused by advanced perio- dontal disease in the upper anterior region that prevented him from chewing properly.
Treatment plan Following a prior, thorough peri- odontal treatment plan, the decision was made to extract the four ante- rior teeth and, during the same surgery, to place two immediate implants in positions 12 and 22 using guided surgery. Dental implants are a highly
predictable treatment and an excel- lent choice for restoring missing teeth. Research has furnished us with digital dental systems that are swiftly taking over from conventional techniques. These technologies offer numerous benefits for patients, clinicians and the prosthetics laboratory, and create new opportu- nities in interdisciplinary workflows, making treatments more precise and comfortable and improving the quality of the outcome. Using diagnostic imaging
techniques and new planning soft- ware, clinicians can place implants in a predetermined position at the same time as considering the imme-
Fig 1 Patient’s initial condition Fig 2 Images of the final prosthesis in the mouth
Fig 3
Images produced by the planning software
diate or final prosthetic restoration and designing the surgical splint that will guide the placement. Designing the prosthesis using
CAD/CAM and milling it at high speed are highly beneficial, as they result in a significant improvement to the fit between implants and struc- tures, leading to better long-term results and outstanding reliability in treatments using implants.
Case overview When the patient visited the clinic, diagnostic tests revealed he had lost a considerable amount of bone in the anterior region due to periodontal disease. The decision was made to extract the four teeth
Fig 4
Screenshots of the process to design the surgical guide and the temporary prosthesis
and to place the implants during the same surgery. To do this, a technique was required that would enable us to orientate ourselves spatially and which would indicate the direction of the implant placements in relation to the patient’s alveolar process in the remaining bone. The surgery was planned using
3Shape’s Implant Studio software, a tool that enables prosthetic plan- ning to take place at the same time as the planning of placement of the implants and the design of the surgical guide used in the treatment. One of the advantages of this
software is that it enables us to Continued »
Scottish Dental magazine 65
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