J Korean Acad Prosthodont.  2008 Dec;46(6):634-638.

The management of a complex implant case using CAD-CAM technology: A clinical report

• Park EJ

Abstract

PURPOSE: The application of computer-aided technology to implant dentistry has created new opportunities for treatment planning, surgery and prosthodontic treatment, but the correct selection and combination of available methods may be challenging in times. Hence, the purpose of this case report is to present a combination of several computer-aided tools as approaches to manage complicated implant case. MATERIAL AND METHODS: A 47 year-old female patient with severe dental anxiety, high expectations, financial restrictions and poor compliance presented for a fixed rehabilitation. A CT scan with a radiographic template obtained with software (SimPlant, Materialize, Leuven, Belgium) was used for treatment planning. The surgical plan was created and converted into a stereolithographic model of the maxilla with bone-supported surgical templates (SurgiGuide, Materialise, Leuven, Belgium), that allowed for the precise placement of 7 implants in a severely resorbed edentulous maxilla. After successful osseointegration, an accurate scan model served as the basis for the fabrication of a one-piece milled titanium framework using the Procera (Nobel Biocare, Gothenburg, Sweden) technology. The final rehabilitation of the edentulous maxilla was rendered in the form of a screw-retained maxillary metal-reinforced resin-based complete prosthesis.
RESULTS
Despite challenging circumstances, 7 implants could be placed without bone augmentation in a severely resorbed maxilla using the SimPlant software for pre-implant analysis and the SurgiGuide-system as the surgical template. The patient was successfully restored with a fixed full arch restoration, utilizing the Procera system for the fabrication of a milled titanium framework.

Keyword

Edentulous maxilla; Computer-aided surgery; Milled titanium framework

MeSH Terms

Compliance
Computer-Aided Design
Dental Anxiety
Dental Porcelain
Dentistry
Female
Humans
Maxilla
Metal Ceramic Alloys
Osseointegration
Prostheses and Implants
Prosthodontics
Surgery, Computer-Assisted
Titanium
Dental Porcelain
Metal Ceramic Alloys
Titanium

Figure

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  Fig. 1. Computer-aided surgery design.

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  Fig. 2. Stereolithographic model and implant placement using surgical template.

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  Fig. 3. Scan model fabrication.

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  Fig. 4. Tooth set-up and stone index.

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  Fig. 5. Prototype for Ti framework.

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  Fig. 6. Ti framework.

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  Fig. 7. Final Prostheses.

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