Predictable Immediate Extraction and Provisional - Case study
INTRODUCTION
The replacement of a single central incisor may be one of the most demanding implant treatments clinicians face. Still, clinicians have been able to achieve aesthetic results in these challenging cases through excellent treatment planning and meticulous surgical placement. The following case study highlights how Dr. Zokol was able to integrate Inliant® into his treatment plan providing an excellent result for the patient in one visit – utilizing the patient’s extracted tooth as the immediate provisional.
Increasing the predictability of implant treatment is a primary goal of our company’s product. The combination of the clinician’s skills and Dynamic Surgical Guidance technology enhances patient outcomes. The aesthetic result was achieved with the assistance of the device’s real-time three-dimensional feedback.
PATIENT:
32 year old healthy male(Fig 1) with a full complement of healthy teeth, with the exception the maxillary right central incisor. This tooth was diagnosed with non-restorable external resorption at the palatal alveolar crest and referred for extraction and implant-supported restoration. The treatment plan for this case was completed prior to removal of the maxillary right central incisor. The position of the Inliant Fiducial™ is identified as per the company’s instructions. The essential criteria for Fiducial placement includes:
- adequate visibility of the laser engraved optical markers on the handpiece concurrently with the Patient Tracker, the Patient Tracker is inserted into the Fiducial at time of surgery; and
- non-interference with orofacial structures and movement of the handpiece during the surgical procedure (Fig 2).
Once the Fiducial has been properly secured in place, a CBCT scan is taken and the DICOM files are opened in the Inliant software. The Inliant treatment plan is completed and saved.
The patient is returned to the operatory for surgery. The maxillary right central incisor is extracted atraumatically and the socket is properly debrided and prepared for the implant osteotomy.
The implant, now delivered, is torqued to the manufacturer’s specifications, the balance of the socket is grafted and preparations are made to fabricate an immediate provisional screw-retained restoration.
A post-operative CBCT scan is taken to verify surgical accuracy (Fig 9). In most normal clinical situations, a single implant is often performed without templates or guidance systems. In cases complicated by the close proximity of adjacent teeth or vital structures, there is merit in utilizing protocols to ensure a high degree of clinical accuracy.
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