Initial situation.

Impression copings in place.

Post-op panoramic radiograph with restoration.

Definitive restoration.

Definitive restoration.

0 Evaluation & Diagnosis
1 Treatment Planning
2 Progress & Completion

Patient cases:

Complete-arch treatments

(Edentulous)

Treatment of a failing maxillary dentition with an implant-supported restoration

Lead:

Regina Mericske-Stern

Evaluation & Diagnosis

Initial situation.

Existing removable denture.

Model analysis. Collapsed posterior bite.

Model analysis. Deep overbite.

Model analysis. Instable occlusal contact situation.

Initial periapical radiographs.

Treatment Planning

Treatment planning. Buccal flange minimal or not required for sufficient facial support.

Treatment planning. Ideal implant axis is aimed with regard to bone and tooth.

Treatment planning. Ideal implant axis is aimed with regard to bone and tooth.

Treatment planning. Extraction sockets teeth #12,21 (FDI) without bone formation. Socket #23 (FDI): socket preservation with BioOss not complete - buccal augmentation needed (local GBR).

Treatment planning.

Treatment planning.

Treatment planning.

Treatment planning. Ideal implant axis can be achieved with regards to bone and tooth axis for screw retention.

Treatment planning. Buccal deficit well visible.

Treatment planning.

Treatment planning.

Progress & Completion

The implant positions have been transferred into a surgical guide.

Surgical guide in situ.

Implants on right side are placed without a flap.

Implants on left side are placed with raising of a flap and GBR.

Impression copings in place.

Individual impression tray for open-tray impression. Holes have been covered to avoid wax excess, but allow impression copings to pass.

Provisional restoration.

Post-op panoramic radiograph with restoration.

On the provisional restorations areas have been marked which need to be corrected for the final restoration.

Definitive restoration. Placement and adjustment of plastic temporary abutments according to silicone matrix.

Definitive restoration. Wax-up of implant bridge framework as needed to receive ideal veneering support.

Fixation of implant bridge framework in wax-up holder of NobelProcera scanner. Framework is scanned and sent for production.

Zirconia implant bridge framework.

Veneered definitive restoration.

Definitive restoration in situ.

Definitive restoration.

Definitive restoration.

Definitive restoration.

Questions

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Team members

Regina Mericske-Stern

Prosthodontist

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