Case 149 | The Award 2017 | Egypt

Case 149 | The Award 2017 | Egypt


Dr. Amr Elkhadem / Ahmed Kotb / Marian Ahmed Roshdy / Huda Fakhry Saeed / Omar M. Mahfouz

Full mouth rehabilitation case using minimally invasive guided implant placement.


The patient is a 45 years old female with few remaining teeth and class II skeletal relationship. the patient had a deep bite with slight facial collapse
Due to prolonged tooth loss in the lower arch noticeable vertical bone loss can be seen
the case was planned on bluesky plan 3 and flapless guided surgery was done
in the second stage custom implant abutments were designed on dental wings software to correct the anatomically compromised implant sites. the patient was restored with a full anatomical CAD CAM multi layer zirconium bridge.

_1Preoperative photos for the patient with few remaining anterior teeth and deep bite _2

Diagnostic mounting made with anterior jig, facebow transfer at a raised VDO

_3Diagnostic wax up of the case _4Trial waxup for closure of the diastema _5Wax up is duplicated with acrylic and barium sulfate mixture. the radio-opaque scan template is made with holes at the suggested prosthetic centers and border serrations for software superimposition _6Implant planning for the lower arch. the implant site at #32 has relatively thin alveolar crest. the implant is planned for slight sub crestal position and expansion simulation was done. _7The implant at 36 is severely lingually inclined to avoid sublingual perforation. simulation for angular correction was planned _8Implant planning for the upper arch _9Because the waxing at the right side was not ideal, virtual setting was done and implant were planned in #15 and # 17 _10The final design for the maxillary and mandibular guides _11 _12Implants were placed in flapless approach except in number 36. a small incision was made to avoid laceration of the soft tissue due to narrow band of keratinized mucosa _13Closed tray impressions for the lower arch _14Designing custom zirconium abutments on ti base models. Note how lingually inclined is the implant at #36 _15 _16 _17 _18Upper and lower virtual on the DWOS for full anatomical design _19Full CAD CAM design _20 _21 _22

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Case 149 | The Award 2017 | Egypt ultima modifica: 2017-03-01T15:11:20+00:00 da Team Zerodonto

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