The case history is designed to collect all patient data in order to allow a correct diagnosis.
The dental visit aims to assess the general state of health of the mouth, preventive care, and the evaluation of operating spaces as a reduced oral opening may prevent the correct execution of the technique.
The protocol of the double scan is provided only for cases of total edentulism.
If the study has a CT or a conebeam, the prosthesis itself can be connected to the Universal stent that will be removed after the second acquisition.
If the patient already has a total prosthesis which is appropriate for the treatment plan the same must be transformed into the scanning prosthesis.
This process is done by applying radiopaque balls (or other radiopaque markers) directly on the flanges of the prosthesis arranged in a staggered manner and in a minimum number of 5 units in the outer part and 3 units in the inner part.
CT acquisition of the prosthesis congruous with Universal Stent.
CT acquisition of the prosthesis congruous with the radiopache markers.
Both CT acquisitions must be imported within the design software in order to perform the alignment.
This step allows a correct implant planning having more anatomical information like the height of the mucosa.
The CT or conebeam exam must be acquired by the design software (Implant 3D and derivatives), so as to develop the case.
The order of the surgical guide must be made online through the portal BioOrd (clienti.bio-nova.eu).
It is possible to receive the STL file of the surgical guide for printing in house or to directly receive the finished surgical guide, printed by Bionova with 3Dad ultra high resolution printers.
• It is important to avoid creating anaesthetic boluses that can prevent a proper housing of the guide.
GUM TISSUE REMOVAL
• Performed by means of a suitable Guided Gum Tissue Remover after having housed the guide.
THE SURGICAL OPERCOLUM
• The surgical guide should be removed to facili- tate the removal of the operculum of the mucosa.
• Create the housing crestal plate of the implant head by removing all interference related to the progress of the alveolar crest.
• Starting from the first cutter of length 8 mm, the subsequent longer cutters work guided both by the bushes of the surgical guide and by 8 mm of the pilot cutter.
From the point of view of the sequence of the cut- ters we must consider that these may vary betwe- en the various types of implant and in relation to the quality of the bone in the implant site.
LAYING THE IMPLANT
• Special fitters screwed to the implant are used so as to bring the implant to the height while maintaining the insertion axis in line with the software project.
With these fitters it is also possible to trace the position of the connection system.
• If provided or fitting healing bolts or screws of the first surgical step.
• The choice to perform an immediate loading is at the discretion of the professional performing the operation.
Certainly the ModelGuide technique, thanks to the option of making a temporary prebuilt prosthesis, can facilitate this therapeutic choice where the clinical conditions and literature data make it viable.