Dental Asia Jul/Aug 2020

User Report DENTAL ASIA JULY / AUGUST 2020 34 A 79-year-old male patient presented an unremarkable health history. Examination (both clinical and radiographic) indicated moderate to advanced bone loss affecting many of his upper and lower teeth; secondary decay was diagnosed on the abutments of his fixed dental prosthesis, and Teeth 15, 16 and 28 had a poor prognosis and were planned for extraction. TREATMENT PLAN The goal of the treatment was to rehabilitate the upper arch with a combination of crowns and implant-retained restorations to UPPER FULL ARCH REHABILITATION USING 3D PRINTED TEMPORARY RESTORATIONS provide the patient with a fixed solution. The accuracy of image registration between the CBCT and IOS scans can be improved with radiographic markers (composite blobs). Removing sources of radiographic scatter, in this case, the porcelain-fused-to-metal (PFM) bridge, also improves the accuracy. By Dr Anthony Mak Fig. 1i-ii: Pre-operative smile and orthopantomogram Fig. 2: Occlusal and lateral view after periodontal treatment and extraction of teeth 16 and 28 Fig. 3: The use of radiographic reference markers, such as G-ænial Universal Injectable composite with a radiopacity of 250% Al, does not result in radiographic scattering during CBCT scans. Prior removal of the porcelain-fused-to-metal (PFM) bridge also reduces radiographic scatter caused by the metallic components of the prosthesis Fig. 4: Intraoral surface scans (IOS) before and after removal of the original PFM bridge superimposed on the CBCT scan: this facilitates the planning of implant placement from a restorative perspective in a restoration driven implant placement (3Shape Implant Studio software) Fig. 5: Planning of implant placement. A surgical guide is designed based on the desired implant position (3Shape Implant Studio software) Fig. 1i Fig. 2 Fig. 4 Fig. 5 Fig. 3 Fig. 1ii