Contests The Prosthocontest 2019/ 29 May 2019/

Case 101 | Paweł Paszkiewicz – Poland | Prosthocontest2019

Paweł Paszkiewicz

Radoslaw Jadach

When your treatment becomes a disaster and finally, after years you finally got it to the end..

The failure of my lifetime.. This is how it ends when you don’t have a plan.. After 4 (yes – FOUR) years of struggling with my patient we finally accomplished.. I wanted to be sure if it ‘s gonna work so last pics are the 6 months recall post last op..

In short – no plan – bad overall effect.. Radosław Jadach helped me to manage the surgery, Piotr Nagadowski and Jacek Świecimski from Natrodent managed PIC scans and 3D CAD/CAD design and finally – Przemyslaw Gorecki has taken care of the final function and esthetics..
Our patient hates us all, but however- we’re very thankful because thanks to her patience – nowadays we have developed a workflow which could close the case within weeks for planning / implants & temporary design, where after 6-9 months another week would be necessary for designing and fixing the finals..  It all stared when I asked a surgeon to place implants, no plan, no smile design, no guides, no CBCT..

And then.. it all started to fall.. Because of a gagging reflex I wasn’t been able to take a conventional impression, so decided to use an intramural scanner.. But those days I haven’t had any idea either how to use it or what limitations of the technology are.. I’ve paid my prize..

Then – I didn’t know how to design the smile, as well as my lab didn’t know how to read the designs.. failed again..  And at the end – we did’t listen to our patients needs so the final outcome was my worst nightmare ever.. So what to do now?? I’ve called my fellow surgeon two get some help..

And the rest of the story is on the photos..  Explantations, grafts, digital impressions using different kind technology of scanning and implant abutment solutions, which also made me providing some direct comparisons and gaining a dose of knowledge I’ve rarely had an opportunity to learn.. on my own failures..  At the end.. Our patient hates us less.. but we held on, providing her a final solution..

Could we do better? of course we could.. Now we’re even up to visualize what could have gone better in 5-10 minutes..  Anyways, digital Dentistry works and makes us working better, easier, more predictable and much faster than before..

I hope you like it !!!