3D Implant Planning: A Case Study

mm Written by Andrew Sedler

According to the Centers for Disease Control and Prevention (CDC), 42.2% of adults 30 years or older had total periodontitis in the United States. Periodontal disease is the main cause of tooth loss in adults. Rehabilitating patients suffering from tooth loss has many options. Fixed implant-supported restorations are one of the leading treatment options that offer significant improvements to the lives of those suffering from tooth loss.

SMART 1 Cementable

Implant-supported fixed restorations begin with careful planning and require successful implant placement. Ideal implant placement ensures both successful esthetic and prosthetic outcomes.

The use of three-dimensional (3D) implant positioning software has made a significant impact on providing proper implant positioning. These programs help with preoperative planning by taking into consideration both functional and prosthetic parameters leading to successful implants.

A 3D map can then be transferred into the form of a surgical guide to be used at the time of surgery to ensure proper implant positioning, including depth and angulation.

A surgical guide can provide the following:

  • Precision of implant placement
  • Implants are placed in less time
  • Minimally invasive surgery
  • Accidental damage to critical structures such as nerves is avoided
  • Immediate loading of implants is achievable

In the case of fixed implant-supported restorations, the planning and placement of implants have an improved outcome over traditional freehand dental surgical procedures.

Case Study

3D Implant Planning - Burbank Dental Lab - Los Angeles - Burbank

The following case presented with the patient showing signs of periodontitis (see above image). The dental exam ultimately revealed that the patient needed complete extraction of her natural dentition. It was decided that this patient would benefit from implant-supported fixed restoration.

The treatment plan involved placing 12 fixation Surgikor implants. This would entail six implants in the maxilla and six implants in the mandible.

An implant guide for both the upper and lower implant placement was created by Dr. Aaron Paz using Surgikor’s scan implant guide. This requires the use of a cone-beam computed tomography scan (CBCT) of the patient.

This data is used to provide the best possible positioning of the implants both in terms of the patient’s oral anatomy and the restorative plan. Each detail is designed in the 3D implant positioning software, including the implant’s location, depth, and angulation.

3D Implant Planning - Burbank Dental Lab - Los Angeles - Burbank
3D Implant Planning - Burbank Dental Lab - Los Angeles - Burbank

The design software created a virtual 3D model of both the maxillary and mandibular arch.

3D Implant Planning - Burbank Dental Lab - Los Angeles - Burbank
3D Implant Planning - Burbank Dental Lab - Los Angeles - Burbank

Once the treatment and design were approved, the surgical guide was fabricated. The surgical guide is produced using a 3D printer. The guide is made from a photopolymer resin. Titanium drill sleeves are placed manually into the guide, which will have an adaptation area that is unique to the patient’s oral anatomy.

With the case designed and the guide produced, the next step is to perform the surgery. Dr. Sam Harouhi performed the surgery using the surgical guide. Multi-unit abutments were placed using extensions to verify the angulation (see image below).

3D Implant Planning - Burbank Dental Lab - Los Angeles - Burbank

Immediately following surgery, the case was digitally scanned using scan abutments. This scan was then sent to Burbank Dental Lab for fabrication of a PMMA temporary fixed implant-supported restoration. The PMMA temporary was returned for insertion within 48 hours.

3D Implant Planning - Burbank Dental Lab - Los Angeles - Burbank
3D Implant Planning - Burbank Dental Lab - Los Angeles - Burbank

PMMA (polymethyl methacrylate) Temporary

This case was done using a digital workflow. The PMMA temporary was designed according to the treatment plan and characterized to ensure the esthetic criteria for this case were met.

PMMA restorations from Burbank Dental Lab provide the following benefits:

  1. Provides the most cost-effective temporary option
  2. Made from a strong and resilient material
  3. Does not wear down natural dentition
  4. PMMA is easy to polish and easy to repair
  5. Reduces impact forces which helps keep them from transferring to the implants.
Advanced Adhesive Dentistry & The Supre-Gingival Protocol
Narrow Diameter Implant Workshop

Implant-Supported Restorations

The next step for a case like this is to fabricate a final implant-supported prosthesis. This further ensures a stable long-term solution to the patient’s tooth loss. The benefits of fixed implant-supported restorations include:

  • Minimizes facial sagging by providing support to the face
  • A more secure functional option when compared to a removable denture
  • Helps to promote bone growth and stimulation, helping to keep the jaw bone healthy.
  • More comfortable than a traditional denture
  • Mastication is improved
  • Offers more security to patients as this type of restoration will not slip
  • Superior esthetics are achieved

In addition, there are other options to evaluate when deciding on restoring the final implant-supported case.

The other restorative options include:

SmartComposite Hybrid

SmartComposite: A Smart Answer to Fixed Dental Restorations
  • Easy to polish and repair intraorally
  • When compared to acrylic, the composite hybrid is less likely to chip
  • Lightweight
  • Wears at about the same rate as a natural tooth
  • Very durable

ZIRMAX M

ZIRMAX
  • Zirconia offers the strongest option
  • Zirconia is the least likely to chip of all the materials
  • Patients often remark that this feels the most like natural teeth.
  • Well over ten years of clinical success

Porcelain fused to metal hybrid

Porcelain Fused to Metal Hybrid
  • This is the most expensive option
  • Offers the best esthetics
  • Is the most versatile of the options
  • Requires the least vertical of any other hybrid option.
Free Success Guide - Dental Lab in California

This case had a great result and provided the patient with much-needed improved oral health. Her smile was improved, as was her overall ability to function. Guided surgery offers superior implant results. The implants are placed with precision, eliminating the chances of causing damage to facial structures.

Burbank Dental Lab has completed thousands of fixed implant-supported restorations. Call or chat with us today regarding your next implant case.

Burbank Dental Lab would like to thank Pinhas Rahav of Surgikor Implants for the photos and notes for this case study.

All On X Success Guide

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Slide 1

Fabrication
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Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

Our New
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Fabrication
of the future
is here!

Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

Our New
State-Of-The-Art
3d Printers

Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.