A Digital Approach to Immediate Placement with Implant Concierge

 

Case History

The patient is a 65 year-old female with a history of smoking, no known drug allergies, and no medications. The patient has

an existing "Snap-On-Smile" from past treatments, and had opted to have her remaining teeth extracted for implant

treatment.



Current Dentition Dental Implant Surgery Surgical Guide Stent

Patient's remaining dentition

Snap On Smile Restorative Dental Implant Surgery

"Snap-On-Smile"


 

For this complex surgery, Dr. Wilson, Dr. Stewart, and Dr. Pope chose to utilize guided surgery for the advantages it provides in predictability, accuracy, and efficiency. This also allowed them to plan for the delivery of a surgery-ready full arch provisional. Utilizing Implant Concierge as their guided solution, 3 essential pieces of information were submitted following the Implant Concierge protocol:

Cone Beam CT Digital Impression Guided Dental Implants Surgical Stent

The CBCT scan was captured by iMagDent Dallas. iMagDent Dallas ensured a full-arch CBCT scan was captured with the patient out of occlusion per the Implant Concierge scanning protocol. A diagnostic cast of the patient's current dentition was taken and digitized for surgical guide design.

A digital impression of the patient's "Snap-On-Smile" provided:

1 - Ideal restorative information for implant planning.
2 - Initial design of the Anchor Pin Surgery-Ready PMMA Provisional.

 

Implant Concierge - Virtual Implant Planning


 

Dental Implants Guided Surgical Stent Straumann Drill Sequence Protocol

 

A final treatment plan was provided for reference, outlining each planned implant position in detail as well as material information.

 

Cone Beam CT Virtual Implant Planning Guided Surgical Stent

 

Cone Beam CT coDiagnostiX Segmentation Virtual Implant Planning Guided Surgical Stent

A step-by-step document was also provided. The case was to be delivered via a series of surgical guides. This document outlined the the sequence and seating of each guide, as well as the pick-up process for the immediate temporary.

Implant Concierge - 3D Printed Guides


 

 

3D Printed Model Surgical Guide Stent Anchor Pin Guide

 

Anchor Pin Guide

A tooth borne anchor pin guided was designed to establish the anchor pin osteotomies prior to extraction of the teeth. The anchor pins would be the foundation on which the surgical guide and provisional orientation were confirmed.

 

3D Printed Model Surgical Guide Stent Anchor Pin Guide

 

 

3D Printed Model Surgical Guide Stent Dental Implant Surgery

 

Surgical Guide

A tooth borne anchor pin guided was designed to establish the anchor pin osteotomies prior to extraction of the teeth. The anchor pins would be the foundation on which the surgical guide and provisional orientation were confirmed.

 

3D Printed Model Tissue Supported Surgical Guide Stent Dental Implant Surgery Anchor Pins

 


3D Printed Tissue Supported Surgical Guide Stent Dental Implant Surgery Anchor Pins

Anchor pin osteotomies being established through the Implant Concierge Anchor Pin Guide using the Anchor Pin Drill.

Anchor pins being fixated into place through the Implant Concierge Surgical Guide. The anchor pins are push pins that are passively retained by pressing the pins to depth.

Implant osteotomies being prepared using the Straumann drills and handles through the Implant Concierge Surgical Guide

 


Dental Implant Surgery Tissue Graft Guided Surgery3D Printed Tissue Supported Surgical Guide Stent Dental Implant Surgery

Implant osteotomies established. Implants were delivered through the Implant Concierge Surgical guide as well using the Straumann Fully Guided Kit.

3D Printed Tissue Supported Surgical Guide Stent Anchor Pins Dental Implant Mounts

Implants and mounts delivered.

3D Printed Tissue Supported Surgical Guide Stent Anchor Pins Dental Implant Mounts

Implants and mounts delivered.

Guided Dental Implant Surgery Tissue Graft Temporary Cylinders

Temporary cylinders delivered and trimmed.

Guided Dental Implant Surgery Tissue Graft Angled Abutments Temporary Cylinders

Temporary cylinders delivered and trimmed.

 

Guided Dental Implant Surgery Tissue Graft Temporary Cylinders

Temporary cylinders delivered and trimmed.

Immediate Full Arch PMMA Provisional


Guided Dental Implant Surgery Immediate PMMA Passive Fit Bridge Provisional Design Milling

Implant Concierge full arch provisional design.

Implant Concierge PMMA milled full arch provisional.

 

Guided Dental Implant Surgery Immediate PMMA Anchor Pin Passive Fit Bridge Provisional Pick Up and Delivery

Full arch Provisional orientation established by the anchor pin osteotomies and fixated into place by the anchor pins.

Full arch Provisional pick-up completed, trimmed, and delivered.

Guided Dental Implant Surgery Immediate PMMA Anchor Pin Passive Fit Bridge Provisional Immediate Smile

After a smooth and successful implant surgery and provisionalization, the patient was able to leave with teeth the same day.

 

Complex Partially Edentulous: APG Passive Fit Bridge


Dental Implant Surgery Digital Workflow 3D Printed Anchor Pin Guide Surgical Guide Stent PMMA Passive Fit Bridge Provisional


 

Thomas G. Wilson Jr. DDS, PA

THOMAS G. WILSON JR. DDS, PA

PA BOARD CERTIFIED PERIODONTIST

Thomas G. Wilson Jr., DDS, PA, is a board certified periodontist who has been a private practitioner of periodontics in Dallas since 1974. His practice emphasizes state-of-the-art, minimally invasive nonsurgical and surgical treatment of gum diseases, utilizing advanced visualization and techniques that restore health to previously diseased tissue. Dr. Wilson also focuses on rebuilding lost oral tissue to help patients regain normal function, while ensuring that the teeth and gums look and feel natural. In cases where teeth have been lost, Dr. Wilson works in close collaboration with a restorative dentist to provide dental implants, giving patients the look and function of a natural dentition. Dr. Wilson has taught his innovative techniques to colleagues around the world. He is the author of numerous professional publications and books on periodontics and implant dentistry. He also is a Clinical Associate Professor at the University of TX Health Science Center at San Antonio Dental School and Baylor University College of Dentistry. He has served as editor-in-chief of an international dental journal, been an Associate Editor for The Journal of Periodontology and is currently Editor in Chief for the journal Decisions in Dentistry.

 

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