52
          
        
        
          
            |
          
        
        
          
            cerecdoctors.com
          
        
        
          
            |
          
        
        
          
            quarter 3
          
        
        
          
            |
          
        
        
          
            2013
          
        
        
          | | |
        
        
          
            pat e l
          
        
        
          
            4
          
        
        
          
            5
          
        
        
          
            6
          
        
        
          
            7
          
        
        
          
            8
          
        
        
          
            9
          
        
        
          
            10
          
        
        
          
            11
          
        
        
          
            12
          
        
        
          
            Fig. 4: Reconstructed Pan from
          
        
        
          
            Galileos CBCT
          
        
        
          
            Fig. 5: Patient in repose: Teeth an esthetic
          
        
        
          
            concern, no soft tissue esthetic concerns
          
        
        
          
            Fig. 6: Phonetic evaluation
          
        
        
          
            Fig. 7: Smile evaluation for esthetic concerns
          
        
        
          
            Fig. 8: Retracted view of defect for site
          
        
        
          
            #24-27
          
        
        
          
            Fig. 9: CEREC Guide Scan for implants
          
        
        
          
            #24 and 27
          
        
        
          
            Fig. 10: CEREC SSI Impression
          
        
        
          
            importation of soft tissue impression
          
        
        
          
            of edentulous site
          
        
        
          
            Fig. 11: CEREC SSI Impression
          
        
        
          
            importation of prosthetic wax-up of
          
        
        
          
            Denture teeth on Diagnostic Model
          
        
        
          The patient was presented with
        
        
          multiple options including the following:
        
        
          conventional
        
        
          removable
        
        
          prosthetics,
        
        
          tooth-supported FPD, implant-supported
        
        
          removable and implant-supported fixed.
        
        
          The patient requested implant-supported
        
        
          fixed.
        
        
          On our first appointment, a diagnostic
        
        
          wax-up was performed with denture
        
        
          teeth on his diagnostic model to show
        
        
          the amount of soft tissue that would be
        
        
          required prosthetically. We scanned
        
        
          the model with the CEREC Bluecam
        
        
          with and without the teeth. The optical
        
        
          impressions were then imported into the
        
        
          CBCT scan for further evaluation and
        
        
          treatment planning of three endosseous
        
        
          implants using the restorative wax-up
        
        
          provided by the optical impression.
        
        
          The patient was presented with the
        
        
          fixed implant treatment using Galileos
        
        
          1.9.4 software. Due to time limitations
        
        
          and insurance coverage, the patient
        
        
          requested we actually start treatment the
        
        
          day of his initial consultation. Using the
        
        
          diagnostic models, two CEREC Guide
        
        
          scanning appliances were fabricated due
        
        
          to limitation in placing three CEREC
        
        
          reference bodies simultaneously. Patient
        
        
          underwent two additional CBCT Scans,
        
        
          and the CEREC Guides were fabricated
        
        
          
            13
          
        
        
          
            14
          
        
        
          
            15