using cbct for side by side implants

Copyright © 2011 Idondivi, Inc. All rights reserved.

Categories ; Posterior, CBCT, multiple implants, Nobel Biocare,

2 Copyright © 2011 Idondivi, Inc. All rights reserved

There is bone , but is it in the right place for our prosthetic needs ?


cbct


VPS Is radio opaque, a small impression (or a full arch impression) worn during

CBCT scanning allows visualization of the soft tissues in relation to the bone.

Transfer to the cast is simple


A small VPS bite registration material impression can be made if the patient has

to go to an external radiology center.

If the CBCT is in the office, then a scan can be made while the full mouth VPS

impression is still in the patients mouth, even if the impression is still setting, so

no time is lost. Note ; these images are from another patient.


# 21 site # 20 site


A pinhole is drilled to place the top of the implant, in this case sub-

crestal to allow sufficient room for the emergence profile


BLP’s in place. The BLP will lock in the bucco- lingual position and the top of the

implant. It still allows precision adjustments to the mesio-distal placement


Wings cut from the buccal and lingual wings for site by site implants


Note the buccal space for flap reflection


0 degree ( green ) rotation blocks ( RP) in place


Correctly exposed radiograph, indicates reliable diagnostic interpretation; no

need for correction , so use 0 degree ( green ) rotation-blocks


Guided surgery does NOT mean flapless surgery, mini-flap allows transportation

of attached tissue towards the buccal


Final osteotomies


Implant placement. Note that because the ridge was not flattened as is common

in non guided surgery the implant # 20 appears to be placed deep. This is

however exactly as planned to get adequate buccal bone coverage. The guided

bone-mill is used to create space to place the healing caps. The body will resorb

as needed.


Sub crestal placement exactly as planned per prosthetic outcome and bone

availability


Initial ISQ , allows monitoring of osseointegration


Attached tissue is positioned buccal of the healing caps.


Guided and delivered as planned

using cbct for side by side implants

Documents

rights reserved vps

rights reserved wings

rights reserved blps

guided bone

small impression

buccal space

guided surgery

mouth vps impression