Page 30 - CEREC Q2 | 2014

28 | CERECDOCTORS.COM | QUARTER 2 | 2014
we have entered a new frontier
of implant dentistry. The days of
numerous visits, multiple doctors, and
less than ideal results are becoming a
thing of the past. Of course, not every case
is ideal for this newworkflow, but thanks
to 3-D diagnostic tools you can pick and
choose which cases are right for you!
What does this frontier look like? It’s
a digital world where you never take
an impression and you have complete
control of the outcomes. Where virtual
planning and guided surgery replaces
invasive surgery. Where chairside
CEREC replaces weeks in the labo-
ratory. Where predictable outcomes
becomes the norm, not the exception.
So how does this frontier work clini-
cally? It’s not totally different than how
it’s already being done. It simplifies by
leveraging digital technologies to inte-
grate multiple phases into a fewer visits.
CASE STUDY
Dustin (Fig. 1) has been a longtime
patient in our dental practice. He calls
one morning with a “twinge” in his left
central incisor, the same central incisor
that was traumatized as a child that we
did some composite bonding on 11 years
ago. That small fracture had finally
materialized into a vertical fracture that
yielded the tooth non restorable (Fig. 2).
Our team quickly and confidently
sprung into action.We gathered aGalileos
3-D CBCT and a CEREC digital impres-
sion along with clinical photographs. This
information quickly yielded an implant
plan that was restoratively
driven (Figs. 3 and 4).
We knew right away that
ridgewidthwas limited and
Implant Magic
Sirona 3-D + CEREC 4.2 +
OmniCam + e.max Abutment
C A S E S T U D Y | | | B Y TA R U N A G A RWA L , D . D . S .
implant is guided into position (Fig. 8) and
primary stability of 35Ncm is achieved
(Fig. 9).
The restorative phase starts with
proper software setup by my assistant
(Fig. 10). I then attach the appropriate
ScanPost to the implant and take a
powder-free, full-color digital impres-
sion (Fig. 11). The result is an accurate
digital implant level impression (Fig. 12)
in a matter of minutes.
We now have complete control of the
design for both the visible crown and the
hidden gingival support (Fig. 13). This
can’t be stressed enough. We are now
able to properly design the restoration
that anarrowimplantwouldbeneeded to
avoid invading the integrity of the buccal
plate. We also discovered that immediate
placement was an option since there was
room for apical extension.
Before Dustin left our office we used
CASEYtovisuallyexplainwhatanimplant
was and what to expect during treatment.
He made firm financial arrangements for
the entire implant treatment in advance
and reserved his appointments. His
surgical guidewas digitally orderedbefore
his car left the parking lot.
Dustin arrives for his implant treat-
ment. He, like anyone losing a front
tooth, is expecting a temporary replace-
ment tooth that day. Thanks to digital
planning we know it’s possible and
thanks to CEREC we know it can be
accomplished.
The surgical phase starts with apical
retention forceps for atraumatic tooth
removal (Fig. 5). The OptiGuide is placed
into the site (Fig. 6) and the guided oste-
otomy is completed (Fig. 7). ANobelActive
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