Enhanced Implant Case Planning Using Dual Scan CBCT of an Existing Prosthesis: Report of a Case

Figure 1. Before treatment esthetic appearance. Figure 2. Clinical presentation before treatment commences. Figure 3. Radiographic presentation of the failing bridge #4–9. Figure 4. Temporary removable partial denture (RPD) in place after first surgery. Figure 5. Frontal view of RPD. Figure 6. Palatal view of wrought wire RPD. Figure 7. Frontal view of healed ridge after the first surgery. Figure 8. Occlusal view of healed ridge demonstrating deficient bone volume in midsection of the edentulous area.

Figure 9. Attachment of radiographic markers to the removable partial denture (RPD) for the dual scan process. Figure 10. Five markers are attached to the flanges of the RPD for computer merging of the two scans. Figure 11. The segmented maxilla in SimPlant Pro after the first surgery. Figure 12. Occlusal view of the segmented maxilla showing the atrophic section of the ridge. Figure 13. Segmented RPD that has been isolated in SimPlant Pro. Figure 14. The RPD is fully seated against the maxilla and adjacent teeth. Figure 15. The RPD showing the radiographic markers on the flanges. Figure 16. Palatal view of the seated RPD. Figure 17. Emergence restorative spaces for long axis planning in SimPlant Pro. Figure 18. Restorative spaces in the occlusal view showing relationships to the prosthetic teeth. Figure 19. Implant positions are adjusted to preserve the cortical plates, and maximum implant length is chosen for stability. Figure 20. The implant diameters and spacing are selected to preserve the biologic width and cortical plates.

Figure 21. Stereolithic SurgiGuide for accurate implant placement surgery. Figure 22. Using of the stereolithic guide supported by natural teeth for implant placement in position, long axis and depth. Figure 23. Radiographic appearance of the implant positions at immediate postimplantation. Figure 24. Encode healing abutments placed at uncovery surgery. Figure 25. Tissue side of the fixed partial denture final prosthesis. Figure 26. Frontal view of the final prosthesis demonstrating the pink porcelain and esthetics of the clinical crowns. Figure 27. Final prosthesis seated in place with the lips retracted. Figure 28. Esthetic appearance of the final prosthesis. Figure 29. Post-treatment segmentation of the maxilla, the final appliance and the implants in SimPlant Pro. Figure 30. The segmented final appliance showing the appropriate position and support by the implants.