iSy Implantatsystem – ein Casebook | 11 Digital Workflow For A Full Arch Monolithic Zirconia Bridge On Six iSy Implants With Guided Surgery Osman Er1, Mücahit Öksüz2, Yelda Dikimciler2 Introduction dtosmaner@gmail.com Function and esthetics are very important for all kinds of dental restorations. For a fixed implant restoration, the positions of the implants and the emergence profiles are very important to have a good result. CAD-CAM systems help us for planning, as well as preparing the guide for guided surgery and fabricating the final restoration. Digital Workflow for a monolithic zirconia bridge on six iSy implants is presented in this case report. ¹ 1 DDs, Private Practice, Istanbul, Turkey 2 CDT, Istanbul, Turkey Materials and Methods The upper and lower jaws were scanned with CEREC AC Omnicam. The digital designs of the teeth were done with CEREC SW 4.4. They were exported with “.ssi” format to merge with the 3D X-rays of the upper jaw. The implants positions were planned on Gallileos Implant SW. The sleeves’ platforms were positioned for the Camlog Guided Surgery Set. Then the plan was exported as “.cmg.dxd”. The guide was designed on the “Inlab SW”and milled in MCX5 by Dentsply Sirona. The guided surgery was performed and 6 Camlog iSy implants were placed on 17, 15, 13, 23, 25, 26 where the bone was optimal. After the osseointegration period, silicone impression was taken with open tray technique. Then the impression was digitalized with InEos X5 lab scanner. Then the bridge was designed and milled with PMMA disc as a temporary and a mock up. The occlusion was checked and the corrections were done according to the mock up and second and final design of the bridge was milled also with PMMA disc. It was examined in the mouth and the monolithic zirconia bridge was milled with “Incoris TZI C” disc. It was sintered, stained and glazed using Dentsply Sirona Universal Stain and Glaze. The final restoration was temporarily cemented in the patients mouth. Digital Workflow helps clinicians and dental technicians for easier, faster and more precise implant treatments. This also helps the pa:ent to have a more comfortable implant treatment. Results and Conclusion Figure 1: Initial Situation Figure 3: Surgical Guide Figure 4: Implants Placed Figure 5: Impression Taking Figure 2: Implant Planning on GALLILEOS IMPLANT SW Figure 6: Impression Digitalization With InEos X5 Scanner Figure 7: Abutments and PMMA Temporary Bridge Figure 8: Monolythic Zirconia Bridge Time, Cost And Technical Advantages Of Fully Digital Workflow For Single And Multiple Unit Implant Treatments Osman Er1, Introduction dtosmaner@gmail.com Digital Technologies have been in our lives since many years and they are used in all fields. They also provide us shorter workflow periods. The accuracy, precision and repeatability are great advantages. With digital dentistry tools, the implant ¹ 1 DDs, Private Practice, Istanbul, Turkey Materials and Methods The upper and lower jaws were scanned with CEREC AC Omnicam. The digital designs of the teeth were done with CEREC SW 4.4. They were exported with “.ssi” format to merge with the 3D X-rays of the both jaws. The implants positions were planned on Gallileos Implant SW. The sleeves’ platforms were positioned for the Camlog Guided Surgery Set. Then the plan was exported as “.cmg.dxd”. The guide was designed on the “Inlab SW”and milled in MCX5 and Digital Workflow helps clinicians and dental technicians for easier, faster and more precise implant treatments. Also we have the full control on these treatments. This helps the pa=ent to have a more comfortable implant treatment. Results and Conclusion Initial Situation treatments are planned from the final restoration to the implants. This reduces all the possible risks like wrong positioning and angulation of the implants. In this case report, Fully Digital Workflow will be presented from planning to the final restoration. CASE 1: Single Implant CASE 2: 3 Unit Bridge on 2 Implants CEREC SW and milled in MCXL by Dentsply Sirona. The implants were placed using Camlog Guided Surgery Burs. After the osseointegration period, the scanning was done with Scanposts and Scanbodies for CEREC. The designs were done with CEREC Premium SW and the restorations were milled with CEREC MCXL using Zlrconium Oxide and Lithium Disilicate. They were finalized and screwed/cemented in the mouth. Tooth Extraction Guide In Mouth Implants Placed Design Steps In CEREC PREMIUM SW Milled And Finalized Restorations Final Result Surgical Guide Initial Situation Digital Planning Guide Design Implant Placement Soft Tissue Shaping With Temporary Restoration Scanning With Scanpost And Scanbody Final Result Marginal bone level around iSy implants placed in healed alveolar ridges with delayed restoration in comparison with post-extraction insertion and immediate load, retrospective analysis at 12 months The aim of this retrospective study is to report, in a period of 12 months, the radiologic marginal bone level outcome of patients treated with single tooth iSy implants when used in healed alveolar ridge with conventional loading protocol, in comparison with an immediate loading protocol in post-extraction sites. 4. Felice P, Pistilli R, Barausse C, Trullenque-Eriksson A, Esposito M. Immediate non-occlusal loading of immediate postextractive versus delayed placement of single implants in preserved sockets of the anterior maxilla: 1-year post-loading outcome of a randomised controlled trial. Eur J Oral Implantol. 2015 Winter;8(4):361-72. 5. Berberi AN, Noujeim ZN, Kanj WH, Mearawi RJ, Salameh ZA. Immediate placement and loading of maxillary singletooth implants: a 3-year prospective study of marginal bone level. J Contemp Dent Pract. 2014 Mar 1;15(2):202-8. References 1. Berberi AN, Sabbagh JM, Aboushelib MN, Noujeim ZF, Salameh ZA. A 5-year comparison of marginal bone level following immediate loading of single-tooth implants placed in healed alveolar ridges and extraction sockets in the maxilla. Front Physiol. 2014 Jan 31;5:29 2. Sanz-Sánchez I, Sanz-Martín I, Figuero E, Sanz M. Clinical efficacy of immediate implant loading protocols compared to conventional loading depending on the type of the restoration: a systematic review. Clin Oral Implants Res. 2015 Aug;26(8):964-82. doi: 10.1111/clr.12428. Epub 2014 Jun 11. Review Maturo P. Rome, Italy* GLOBAL SYMPOSIUM 2018 26-28 APRIL 2018 ROTTERDAM, NETHERLANDS Materials and methods: 16 patients in need of a single-tooth replacement received iSy implants. In Group A 8 iSy implants were placed in healed ridges, with transgingival healing using iSy healing cap and restored with delayed load and restoration. In Group B 8 iSy implants were placed immediately into fresh extraction sockets without flap elevation and restored with immediate non functional loading by using a provisional crown bonded to the multifunctional cap and then snapped onto the implant base. The final restorations were made in all cases after 3 months from the surgery with a screw retained hybrid abutment crown (zirconia bonded to the titanium implant base). The Marginal bone level relative to the implant reference point was recorded at implant placement and after 12 months following surgery using standardized periapical radiographs. All of the periapical radiographs were acquired by a digital system using the photostimulable phosphor (PSP) plate (Kodak CS 7600, Carestream Health, Rochester, NY). Measurements were made on the mesial and distal sides of each implant, calculated as vertical distance between crestal bone level and implant neck using Kodak Dental Imaging software (Kodak Dental Imaging Software 6.12.32.0), measurements were performed twice for each recording and by the same operator. Post-extration Conventional Loading Base Line 1 year Base Line 1 year Pat.# Mesial Distal Mesial Distal Pat.# Mesial Distal Mesial Distal 1pe 2,3 0,9 1,7 1,4 1c 0,1 0,1 0 0 2pe 1,6 1,2 0,3 0,2 2c 0,5 0,4 0,3 0 3pe -0,1 0,1 0 0,3 3c 0,2 0 0,5 0 4pe -0,7 0 -0,9 0,2 4c 0,3 -0,2 -0,5 -0,7 5pe 0,6 0,7 0,4 0,5 5c 0,8 0,4 0,3 0,4 6pe 1,6 1,4 1,6 0,9 6c 0,2 0 -0,3 -0,6 7pe 1,2 0,7 0,6 -0,2 7c 0,8 0,2 0,7 -0,1 8pe 0,1 0,3 0 -0,1 8c 0,6 0,4 0,2 0 Result 0,825 0,6625 0,4625 0,4 Result 0,4375 0,1625 0,1125 -0,0875 Average 0,74375 0,43125 Average 0,3 0,0125 Delta 0,3125 Delta 0,2875 Results: The mean change in marginal bone loss (MBL) after 1year of implant placement was 0.31±0.22 mm in extraction sockets and 0.29±0.20 in healed ridges. Conclusions: Within all the limitations of this study, responses of local bone to immediately loaded iSy implants placed in extraction sockets or in healed ridges with delayed load were similar after one year. Immediate restoration technique by using iSy titanium implant base as abutment and with snapped multifunctional cap (without cement) placed in post-extraction single implants seems not to have influence on marginal bone around iSy implants as compared to conventional delayed surgery and loading in a period of one year. Disclosure: the author declare non conflict of interest * University of Rome “Tor Vergata” - Italy Department of Experimental Medicine and Surgery Behandlungstherapien mit dem iSy Implantatsystem Posterarbeiten Digitaler Arbeitsablauf für eine mono- lithische Zirkoniumdioxid Brücke auf sechs iSy Implantaten mit geführter Chirurgie Osman Er, Mücahit Öksüz, Yelda Dikimciler Funktion und Ästhetik sind bei allen Arten von dentalen Restaurationen sehr wichtig. Bei einer festsitzenden Implantatversorgung sind die Position der Implantate und die Austrittsprofile essenziell, um ein gutes Ergebnis zu erzielen. CAD/CAM-Systeme sind bei der Planung, bei der Vorbereitung der Schablone für die geführte Chirurgie und bei der Herstellung der endgültigen Restauration hilfreich. In dieser Publikation wird der digitale Workflow für eine monolithische Zirkoniumdioxid-Brücke auf sechs iSy Implantaten vorgestellt. (englisch) www.camlog.de/wissenschaft-osman-et-al Zeit-, Kosten- und technische Vorteile eines volldigitalen Arbeitsablaufs für Implantatbehandlungen mit einer und mehreren Einheiten Osman Er Digitale Technologien begleiten unser Leben schon seit vielen Jahren und werden in allen Bereichen eingesetzt. Sie ermöglichen die Reduktion der Arbeitszeiten. Die Genauigkeit, Präzision und Wiederholbarkeit sind große Vorteile. Mit den digitalen Möglichkeiten in der Zahnmedizin können die Implantatbehandlungen im Sinne des Backward Planning von der endgültigen Restauration bis zur Insertion geplant und durchgeführt werden. Dies minimiert mögliche Risiken wie Fehlpositionierung und Angulation der Implantate. In diesem Fallbericht wird der volldigitale Workflow von der Planung bis zur endgültigen Versorgung vorgestellt.v (englisch) www.camlog.de/wissenschaft-osman Marginales Knochenniveau um iSy Implantate, inseriert nach Extraktion im ausgeheilten Alveolarknochen mit verzögerter vs. Sofortversorgung – retrospektive Anlayse nach zwölf Monaten Paolo Maturo Ziel dieser retrospektiven Studie ist es, über einen Zeitraum von zwölf Monaten die radiologischen Ergebnisse des marginalen Knochenniveaus von Patienten zu eruieren, die mit iSy Einzelzahnimplantaten versorgt und nach dem Spätversorgungsprotokoll mit konventionellem Belastungs- vs. Sofortversorgungsprotokoll nach Extraktion versorgt worden waren. Diese retrospektive Studie zeigte nach zwölf Monaten keine signifikanten Unterschiede in der Reaktion des marginalen Knochens auf iSy Implantate, die entweder sofort in Extraktionskavitäten oder in bereits verheilten Alveolarknochen mit verzögerter Belastung eingesetzt wurden. Die Technik der sofortigen Restauration mittels iSy Implantatbasis als Abutment und Verwendung einer aufgesteckten multifunktionalen Kappe ohne Zement bei einzelnen postextraktiven Implantaten scheint den Knochenerhalt um iSy Implantate herum nach einem Jahr im Vergleich zu konventionellen chirurgischen und belastungstechnischen Verzögerungen nicht signifikant zu beeinflussen. (englisch) www.camlog.de/wissenschaft-maturo
RkJQdWJsaXNoZXIy MTE0MzMw