[EO-22] Digital Implant Planning in Anterior Esthetic Area: A Case Report
[Abstract]
[Introduction]
Digital technology has simplified oral rehabilitations procedure significantly. The use of 3D imaging enables precise treatment planning, restoration design and production, thereby improving overall restoratives outcomes.(1) While implant guided surgery is viewed as more accurate and reliable than free-handed method, discrepancies between virtual plan and actual placement can occur due to the surgical learning curve and digital workflow errors.(2)
[Case Summary and Treatment Details]
A 33-year-old male patient came with a chief complaint of missing tooth #12 – #23. The definitive treatment consists of implant placement on #12, #11, and #13 using fully digital guided surgery, guided bone regeneration and zirconia porcelain bridge prostheses. A fully digital implant surgical guide was planned and made by combining CBCT and digital impressions. Implants were positioned on element #12 #11 fully guided, however on element #23 the guide deviates more buccally than the planned placement. Therefore, we decided to perform free-handed placement instead. 6 months follow up for the second stage, we found bone resorption occurred on the buccal area of element #23. Bone graft placement was performed on the defect side. Impression of the implants was done after implant stability and healing of gingiva was achieved, using intraoral scanner. Zirconia bridge was designed and milled digitally. Patients gave consent for this case to be presented.
[Progress and Discussion]
Although digital technology has made implant procedure easier and more precise, an operator is still needed to independently plan the case. In a case of long-span tooth loss, especially esthetic area, the treatment can be complicated. Digital implant planning guided surgery may increase the success rate, however such procedure must be accompanied by careful planning and operator’s experience. The limitations of digital imaging and digital implant software may also cause discrepancies between planning and actual clinical practice.
[References]
1) Bohner L, Gamba DD, Hanisch M, et al. Accuracy of digital technologies for the scanning of facial, skeletal, and intraoral tissues: A systematic review. J Prosthet Dent. 2019 Feb;121(2):246–51.
2) Al Yafi F, Camenisch B, Al-Sabbagh M. Is Digital Guided Implant Surgery Accurate and Reliable? Dent Clin North Am. 2019 Jul;63(3):381–97.
[Introduction]
Digital technology has simplified oral rehabilitations procedure significantly. The use of 3D imaging enables precise treatment planning, restoration design and production, thereby improving overall restoratives outcomes.(1) While implant guided surgery is viewed as more accurate and reliable than free-handed method, discrepancies between virtual plan and actual placement can occur due to the surgical learning curve and digital workflow errors.(2)
[Case Summary and Treatment Details]
A 33-year-old male patient came with a chief complaint of missing tooth #12 – #23. The definitive treatment consists of implant placement on #12, #11, and #13 using fully digital guided surgery, guided bone regeneration and zirconia porcelain bridge prostheses. A fully digital implant surgical guide was planned and made by combining CBCT and digital impressions. Implants were positioned on element #12 #11 fully guided, however on element #23 the guide deviates more buccally than the planned placement. Therefore, we decided to perform free-handed placement instead. 6 months follow up for the second stage, we found bone resorption occurred on the buccal area of element #23. Bone graft placement was performed on the defect side. Impression of the implants was done after implant stability and healing of gingiva was achieved, using intraoral scanner. Zirconia bridge was designed and milled digitally. Patients gave consent for this case to be presented.
[Progress and Discussion]
Although digital technology has made implant procedure easier and more precise, an operator is still needed to independently plan the case. In a case of long-span tooth loss, especially esthetic area, the treatment can be complicated. Digital implant planning guided surgery may increase the success rate, however such procedure must be accompanied by careful planning and operator’s experience. The limitations of digital imaging and digital implant software may also cause discrepancies between planning and actual clinical practice.
[References]
1) Bohner L, Gamba DD, Hanisch M, et al. Accuracy of digital technologies for the scanning of facial, skeletal, and intraoral tissues: A systematic review. J Prosthet Dent. 2019 Feb;121(2):246–51.
2) Al Yafi F, Camenisch B, Al-Sabbagh M. Is Digital Guided Implant Surgery Accurate and Reliable? Dent Clin North Am. 2019 Jul;63(3):381–97.