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Friday, January 19, 2018
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Techniques chirurgical d'implant dentaire Guide chirugical d'implant dentaire Planification d'implant dentaire
Case Study 1

Case description

implant dentaire cas image de l'absence congénitale de la deuxième prémolaire

A 44 years old man with a congenital absence of the second permanent premolar, saving the space by keeping his second primary premolar that has now been extracted.

cas d'implant dentaire image de la planification électronique en implantologie

 

implant dentaire cas image de l'absence congénitale de la deuxième prémolaire A computer assisted implant planning is necessary for the immediate placement of an implant with a temporary crown.

The study shows the need for a minor vertical bone graft.

cas d'implant dentaire permet de visualiser la distribution des zones de différentes densités osseuses The study, illustrated here by the different colors, makes it possible to visualize the distribution of different areas of bone density and evaluate the possibility of installing a temporary crown on implant.
cas d'implant dentaire vue panoramique conventionnelle en 2D On this conventional 2D panoramic view, the available vertical space is evaluated. The bone in the vertical space seems abundant.
cas d'implant dentaire CTscan au côté vestibulo-lingual A selected vestibulo-lingual side cut reveals a significant bone atrophy in the proposed implant site, contrary to the assessment made by means of 2D panoramic. This case illustrates the lack of information associated with a plan based solely on a 2D panoramic view.
cas d'implant dentaire coupe panoramique de l’image CT The CT scan panoramic view clearly reveals the bone deficiency area near the implant site.

The surgical guide

cas d'implant dentaire le guide chirurgical simplant

The surgical guide, computer designed SimPlant 3I-Safe, is checked against the stone model.
cas dèimplant dentaire le guide simplant avec analogue monté sur la plate-forme du guide An analogue is mounted on the guides platform which has been manufactured specifically for the insertion of the implant into its final position in the mouth.

cas dèimplant dentaire avec un pilier temporaire est adaptée à l’analogue

A temporary abutment is fitted on the analogue. A Duralay key is prepared to facilitate the transfer of the abutment in maintaining its proper orientation on the implant.

Pre-operative Condition

cas d'implant dentaire le guide chirurgical simplant Condition pré-opératoire

Pre-operative condition.
cas dèimplant dentaire Chirurgie au moyen d’un lambeau ouvert Open flap surgery.

cas d'implant dentaire - Extraction atromatique avec périotome

Atraumatic extraction with periotome.

Surgical Operation

implant dentaire cas image de l'absence congénitale de la deuxième prémolaire

 

Drilling sequence.
cas d'implant dentaire image de la planification électronique en implantologie Checking the borehole's depth.

cas d'implant dentaire permet de visualiser la distribution des zones de différentes densités osseuses

The 3I-Safe system equipped with a drill stopper ensures precision and safety in this critical surgical step.

cas d'implant dentaire vue panoramique conventionnelle en 2D

Inserting the implant through the 3I-Safe surgical guide.
cas d'implant dentaire CTscan au côté vestibulo-lingual High precision verification for the final adjustment of the implant.
cas d'implant dentaire pose d'un pilier temporaire The temporary pillar is torqued to 30 Newton / cm 2. Evaluation of the bone irregularity around the placed implant. As planned by computer, there is less than 1.5 mm of vertical bone loss.
operation

The temporary crown is cimented. The cement surplus is removed gently. Then we apply the bone particle (connexus) to fill the minor bone deficiency.

Note: an opposed bone regeneration technique was chosen in this case.

operation We finish the adaptation of the flap around the temporary crown.
operation Panoramic view of the implant installed in the mouth with a temporary crown in one sitting, including minor bone grafting .

Prosthetic

Open tray impression technique.

Open tray technique impression.
Abutment placement using a positioning guide Abutment placement using a positioning guide.

Final cementation of the crown

Final crown cementation.

Five month post operative view of bone regeneration following allograph image 1Five month post operative view of bone regeneration following allograph image 2

View of bone regeneration following the allograph.

(Five month post- operative)