Page 26 - CEREC Q2 | 2014

24 | CERECDOCTORS.COM | QUARTER 2 | 2014
two different bone grafting materials
(MinerOss, BioHorizons and Bio-Oss,
Geistlich) were reconstituted andmixed
withPRF (Figs. 12-13). A localized decor-
tication was then performed via intra-
marrow perforations. The first layer of
bone grafting consisted of applying the
corticocancellous MinerOss bone graft
onto the exposed implant threadswithin
the alveolar housing (Fig. 14). The
second layer of bone grafting consisted
of applying the anorganic bovine
Bio-Oss bone graft onto the previously
applied MinerOss bone graft (Fig. 15).
This layeredbone graftwas then covered
with a double layer of a cell-occlusive
resorbable membrane (CopiOs Pericar-
dium membrane, Zimmer) followed by
a final layer of PRF membranes (Figs.
16-17). A periosteal releasing incision
was then performed to allow tension-
free submerged primary flap closure
Fig. 12: MinerOss bone graft
reconstituted and mixed with PRF
Fig. 13: Bio-Oss bone graft
reconstituted and mixed with PRF
Fig. 14: First layer of bone grafting
with MinerOss bone graft
Fig. 15: Second layer of bone grafting
with Bio-Oss bone graft
Fig. 16: Double layer of CopiOs
Pericardiummembrane over
bone grafts
Fig. 17: PRF membranes placed over
CopiOs Pericardiummembranes
Fig. 18: Suturing for tension-free
primary closure
Fig. 19: Uncovering of implants after
three months of healing
Fig. 20: Ideal wax-up after implant-
level impressions
Fig. 21: Wax-up scanned with
Omnicam for Biocopy
21
| | | B O LT C H I
12 13 14 15
16 17 18
19 20
with 5.0 Polypropelene sutures (Fig. 18).
After an uneventful three-months
healing period, the implants were
uncovered via a localized punch-type
incision and 4.8x5 mm healing caps
were placed onto the implants (Fig. 19).
Implant-level closed-tray impressions
were then obtained and sent to the labo-
ratory for the fabrication of an implant
soft-tissue model and the refinement
of the previous wax-up into an ideally
contoured restorative wax-up of the
final restorations (Fig. 20). This wax-up
was then scanned with the CEREC
Omnicam as a Biocopy (Fig. 21), Strau-
mann temporary abutment copings
were modified and scanned as well
(Fig. 22), provisional screw-retained
Lava Ultimate crowns were designed
in the CEREC chairside software (Fig.
23), and then milled with the CEREC
MCXL milling unit and bonded to