Dr. Nicola Barabanti
ALL CLINICAL CASES
The CP patient, aged 44, comes to our attention in January 2010.
The medical history was negative for any pathology of dental interest, is a light smoker and has high expectations aesthetic and functional
At first objective analysis of the oral cavity and in particular of the upper jaw (where she focused our rehabilitation) can be seen a series of restorations and conservation strongly incongruous and a deep bite
The patient has an asymmetrical smile and claims to make it hard to laugh because he is ashamed of his own mouth
At first radiographic glance there is a significant loss of bone support, elements with prostheses, endodontic lesions to load the items 1.4, 1.3, 2.2, 2.3, 2.5, 1.5 and 2.4 of edentulous and incongruous endodontic pins on all the front elements
In agreement with the patient maintain atraumatic extractions items 1.4, 1.3, 1.2, 2.2, 2.3, 2.5, keeping within the central incisors and first molars in order to support the arch provisional.
We create an exact copy of the arch temporary resin added with barium in order to have a template both radiological and surgical.
A soft tissue healing and post-extraction sockets occurred we decement provisional arch and we place the barium to refer the patient to Cone Beam 3D Dental.
Using a software design implant we decide to rehabilitate the patient’s maxillary arch top with 6 plants, taking care to bypass the maxillary sinuses
After having transformed the mask Radiological surgical template we place implants as designed by the emergence of the same heads as possible in correspondence with the occlusal surface of the elements
The placement of prosthetic implants guided necessitated the regenerative bone that was performed with bone substitute of bovine origin and resorbable membrane in both sectors
A suture occurred orthopantomography we make a control to assess the correct positioning of the implant
Six months post surgery the re-opening of the plant and the evaluation of the success of regenerative surgery. In that appointment impression was taken of the position of the plants in order to realize the new interim
At 21 days after the second surgery were placed on the heads of the facilities of the Multi Unit Abutment (4 straight and 2 angled 17 ° to parallelize the stumps). and the new provisional screwed on them. We then proceeded to the extraction of the items 1.6, 1.1, 2.1 and 2.6 with the utmost respect of the socket.
A healing has occurred, we then took the final impression with polyether having sympathized with the transfer of the epoxy resin
The phases prosthetic were performed after taking a facial arc reference and having studied the possible mile line of the smile by making a mounting wax altogether similar to what is used in total hip prosthesis
After trying the first structure in the resin and then in castable material we realize a primary zirconia substructure which in turn is proven by the technique of Sheffield. We care also detect the color of the mucous membranes.
We tighten definitively by clamping 30N primary structure of zirconium and we try to cure the individual elements in lithium disilicate in place. We do the appropriate balancing occlusal them and polish the elements or bench.
The individual elements are cemented with adhesive technique (dual concrete) having the structure treated with a primer devoted to the zirconium and the elements with etched and silanated.
A control one week after cementation both clinical and radiographic allows you to remove any excess cement
Control 2 years after clinical and radiological.
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ALL CLINICAL CASES
