CEREC Doctors

Using Technology to a Higher Level


So although I am a Mentor and a Trainer for HS, I have enjoyed sideline status for a while being busy in private practice and soaking up many discussions here on CD.  Thanks to this forum and many great dentists to both educating and pushing my envelope.

I just got involved with a case the other day that allowed me to use many of my Cerec Tech skills that non-Cerec dentists may find challenging ways to accomplish, but certainly not the same way that we as a Cerec dentists would.

Patient A came in for Recall and had areas of recurrent decay as he usually does due to his less than ideal home care and reveals that he never restored tooth #8 which on prior recalls had a carious lesion.

The pre-op xray shows the extent of the decay and the photo of #8 and provisionally restored with a Cerec Milled Cerasmart crown.

After it was explained to patient A that #8 was not restorable, it was explained that at time of extraction an implant would be place and a temporary tooth would be placed on the implant as long as we could get adequate stability and as long as he understood that this tooth was NOT to be used for any reason other than smiling.  

 

CBCT planning was performed merging Cerec data and CBCT data.

After implant planning was performed, exporting the file cmg,dxd file back to the Cerec software allowed me to create and milled Cere guide 2 for implant placement prior to extraction.

 

Patient A returned a few days later wearing the provisional that was created at the prior visit.  That provisional was removed just before the tooth was extracted so it could be used as the immediate load temp.

The extraction was performed and the guide placed.  After the initial osteotomy was created and guide pin was place an x-ray was taken to confirm position.

Completion of the osteotomy was done and the Straiumann SLA Active implant placement was completed.

Just to confirm position I inserted the Straumann implant delivery abutment.

 

At that time a Strraumann temp abutment was inserted and noted where it needed to be modified to allow for the temp to be luted to it.

The final photos show the completed implant placement and the screw retained provisional.

Contacts were adjusted to remove any touching of adjacent teeth and because his overjet allowed, no contact with the opposing teeth was noted.


​He will be seen for a 1 week post op and regularly for 4 months until integration is completed.

 

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Very nice Jeff!


This is a difficult case. I would probably do a socket shield or extrusion first. The reason I am saying that interproximal bone between 7 and 8 are very thin and after extraction you might loose more interproximal bone and create more recession. I would place implant more mesial. I would not use tibase on this particular case. Gregory


Nicely presented Jeff

 

Mike


Very nice case, like the cerasmart temp idea too!