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Angel Moreno: All-Records-in-One® for immediate loading – a novel technique for manufacturing a full-arch, fixed, implant-supported provisional restoration in the surgical office (Straumann® Bone Level Tapered Implant)

  This case report presents an immediate-loading procedure as an innovative application for the newly described “All-Records-in-One®” impression technique*. This method allows us to fabricate a temporary implant-supported restoration for an edentulous patient in a quick, accurate and comfortable manner for both patients and clinicians. As the procedure is entirely prosthodontically driven, it is highly accurate and has a low incidence of occlusal corrections, thereby substantially reducing the average patient´s chair time. PRODUCT INFORMATION BY THE MANUFACTURER The Straumann® Bone Level Tapered Implant offers excellent primary stability in soft bone and fresh extraction sockets. The tapered form adequately compresses the underprepared osteotomy. It also allows to effecively master your patient’s limited anatomy such as facial undercut, converging root tips, concave jaw structure or narrow atrophied ridges. Building on the clinically proven features of the Straumann® Bone Level Implant, the BLT introduces the powerful combination of Roxolid®, SLActive®, Bone Control Design™, CrossFit® connection, prosthetic diversity, plus a tapered implant body. MORE? All about the STRAUMANN® BONE LEVEL TAPERED IMPLANT on STARGET at a glance. Click here PICTURE DOCUMENTATION Fig. 1 moreno01 Fig. 2 moreno02 Fig. 3 moreno03 Fig. 4 moreno04 Fig. 5 moreno05 Fig. 6 moreno06 Fig. 8 moreno08 Fig. 9 moreno09 Fig. 10 moreno10 Fig. 11 moreno11 Fig. 12 moreno12 Fig. 13 moreno13 Fig. 14 moreno14 Fig. 15 moreno15 Fig. 16 moreno16 Fig. 17 moreno17 Fig. 18 moreno18 Fig. 19 moreno19 Fig. 20 moreno20 Fig. 21 moreno21 Fig. 22 moreno22 INITIAL SITUATION An edentulous healthy 58-year-old non-smoking male, wearing maxillary and mandibular complete dentures presented at our dental office. He complained about their instability and unsatisfactory appearance (Fig. 1). He also reported pain and frequent pressure ulcers caused by the instability of the mandibular denture (Fig. 2) and also by the lack of keratinized tissue. We assessed viable bone from a panoramic radiograph and CBCT scan (Fig. 3), and the patient was offered several treatment options, including fixed, full arch implant-supported restorations in both maxilla and mandible, and also a free gingival procedure to increase the quality of the tissue, which was refused by the patient. For financial reasons, the patient chose a conventional complete denture in the upper jaw and a full-arch, screw-retained hybrid prosthesis in the lower jaw. TREATMENT PLANNING An immediate-loading option was discussed and fully explained to the patient. Once the patient agreed to have the treatment, we made two diagnostic wax-ups for the upper and lower jaws and tried them in the patient´s mouth to check esthetics, vertical dimension and centric relation records. After clinically assessing the esthetics and functional records, we fabricated a definitive complete denture in the upper jaw and a temporary acrylic complete denture in the lower jaw. SURGICAL PROCEDURE The patient received a prophylactic dose of 2g amoxicillin plus clavulanic acid one hour before the surgery. Also, an anti-inflammatory drug (ibuprofen) was prescribed for the day of the surgery and, only if necessary, after the procedure. The surgery was carried out under local anesthesia. A full-thickness flap was raised, and the residual bone was reduced in order to obtain a proper prosthetic space for the restoration and an adequate implant bed (Fig. 4). Five Straumann® Bone Level Tapered (BLT) implants were placed between the mental foramina (Fig. 5) according to the manufacturer´s instructions. All implants displayed a high degree of primary stability, requiring a ≥ 30Ncm torque as tested with a torque-control device. PROSTHETIC PROCEDURE Five Straumann® RC screw-retained abutments were tightened to 35 Ncm over each implant. The height of the abutments was clinically chosen according to the peri-implant mucosa and the 3D position of the implants (Fig. 6). Next, protective RC caps were tightened to the RC screw-retained abutments with 10 Ncm. At this point, the temporary prosthesis, now used as a prosthetic template, was placed in the patient´s mouth (Fig. 7). We then mixed and placed some silicone putty in the prosthetic stent window, and made an impression of the cap shapes at the same time as a centric occlusal record was taken against the upper definitive denture (Figs. 8,9). The silicone putty was removed, and an incision of about 1-2 mm was made (Fig. 10). Separating agent was applied over the silicone putty and was again placed in the prosthetic stent (Fig. 11). Polyvinyl siloxane material was poured (Fig. 12), and an impression was taken while asking the patient to close his mouth, taking care to keep the interocclusal centric record we just performed in the wax-up try-in. Once the impression material had set, we removed the impression (Fig. 13) and cut the entire thickness of the polyvinyl siloxane material corresponding to the mark of each protective cap (Fig. 14). Since we had already applied separating agent before, we were able to again remove the silicone putty material without breaking the impression (Fig. 15). We removed the RC protective caps, and titanium copings were placed over the RC screw-retained abutments and tightened to 15 Ncm. Finally, the prosthetic stent was again placed in the patient´s mouth over each titanium coping (Fig. 16) and autopolymerizing acrylic resin with a medium consistency was poured into the space (Fig. 17). Before this material set completely, we had to check that the occlusal centric relation record was maintained at all times. We waited for about 7 or 8 minutes until the acrylic material had set completely and, finally, we removed it from the patient´s mouth (Fig. 18). FINAL RESULT Once we had removed the unfinished temporary hybrid prosthesis from the patient´s mouth, about 30-35 minutes from the beginning, we had two options: finish it in the surgical office or send it to the lab. In both situations the patient can stay in the waiting room or go for a walk during the process, since his presence is not required. In most cases, and taking account of profitability and our own and the patient´s convenience, the prosthesis is finished by the lab. In his lab the technician pours autopolymerizing acrylic resin to fill any gaps (Fig. 19), trims the prosthesis cantilevers and polishes it in order to obtain the final temporary hybrid prosthesis (Figs. 20,21). Finally, the full-arch, fixed, implant-supported provisional restoration is placed in the patient´s mouth. Fig. 22 shows the clinical situation immediately after placement of the temporary prosthesis as we received it from the lab, about one hour later. Only minor occlusal corrections were needed. Postoperative x-ray control confirmed the correct positioning and fit between the implants and the temporary implant-supported hybrid prosthesis. * “All-Records-in-One®” is a trademark of Createch, Mendaro (Guipúzcoa), Spain. Angel Moreno Lucendo DDS Cofounder of Createch Medical (Spain). Basic and clinical research in digital implant dentistry and implant prosthetics. Private practice limited to implant dentistry and oral rehabilitation. Lecturer at international level. CLINICAL REVIEW The clinical facts behind the Straumann® Bone Level Tapered Implant. Click here BROCHURE Download the Straumann® Bone Level Tapered Implant brochure. Click here The post Angel Moreno: All-Records-in-One® for immediate loading – a novel technique for manufacturing a full-arch, fixed, implant-supported provisional restoration in the surgical office (Straumann® Bone Level Tapered Implant) appeared first on STARGET COM.

The finalist teams of the Excellence in Prosthodontics Award

  Choose your favorite finalist team. Online vote will be open until Sunday, March 19 (11:59 PM GMT). Vote Now Dr. Pascal Magne will award the winning team that will be announced during the IX AIOP Mediterranean Meeting held April 7-8, 2017, in Riccione (Italy). FIRST PRIZE: Straumann® CARES® Intraoral Scanner: A collaboration between: AIOP (Italian Academy of Prosthetic Dentistry) APS (American Prosthodontic Society) JPD (The Journal of Prosthetic Dentistry) ZERODONTO (Free Blog of Dentistry) powered by Straumann The post The finalist teams of the Excellence in Prosthodontics Award appeared first on STARGET COM.

Straumann at IDS 2017: Rocking dentistry like never before!

  March 21-25 2017: More than ever before, Straumann will surprise dentistry at the International Dental Show in Cologne, Germany, by presenting a horn of plenty of innovations, product novelties and services that will shake up the market. Virtual Reality worlds plus a breathtaking show during IDS will rock you to the core. Visit our IDS campaign websites for more information and be there when Straumann raises the roof of the Cologne exhibition hall! Hands in the air for Virtual Reality & Live Rock sessions! Let yourself be  transported to a world of Virtual Reality, with surprising perspectives on groundbreaking innovations. Put on the VR glasses and experience an unparalleled video and audio experience combining information, science and virtual reality. Then let yourself be entertained by live rock sessions and the classic Straumann booth party – every evening during IDS! Who will be the winner of the Straumann® Rock Guitar? This extraordinary piece of art has been handbuilt by one of the most talented guitar makers with original Straumann® parts. Who has submitted the most impressive performance and gained the hearts of the audience? On Friday, March 24 at 17:00 you will find out when we officially hand over the guitar to the winner! The post Straumann at IDS 2017: Rocking dentistry like never before! appeared first on STARGET COM.

Straumann Connections 1/17: Straumann® PURE Ceramic Implant peer-to-peer surgical event in Boston

  Together with Straumann, Drs. Paul Fugazzotto and Anya Rost partnered with their referring dentists and Dickerman Dental Laboratory to create a 5-day surgical peer-to-peer event in their practice near Boston. 28 Straumann PURE implants were placed using computer guided surgery, and were immediately restored with provisional crowns. THE STRAUMANN® PURE CERAMIC IMPLANT The Straumann® PURE Ceramic Implant is the result of more than 12 years of research and development. It has a natural looking ivory color, a feature that makes the implant look more like a natural tooth and supports the clinician in cases of thin gingiva biotype or soft tissue recession. It has a monotype design based on features of the Straumann® Soft Tissue Level Standard Plus and Straumann® Bone Level Implants. Excellent clinical performance with 97.5 % survival and success rate after three years has been shown in a recent clinical study (Bormann KH, Gellrich NC,Kniha H, Schild S, Weingart D, Gahlert M. Publication in preparation 2017). With the Straumann® PURE Ceramic Implant, clinicians can offer their patients a natural and highly esthetic solution, benefitting from favorable soft tissue attachment around zirconia implants. MORE? All about the STRAUMANN® PURE CERAMIC IMPLANT at a glance. Click here STRAUMANN® PURE CERAMIC IMPLANT MONOTYPE MEETS PEER-TO-PEER PARTNERSHIP PROGRAM The goal of Straumann’s Peer to Peer Partnership (P2P) program is to mentor highly experienced clinicians and to give them the confidence to explore in a controlled and secure manner, new technologies and/or procedures outside their comfort zone. An excellent example of this patient focused activity is the recent in-line case series at the clinic of Drs Fugazzotto and Rost in Milton (MA). This surgical-prosthetic event was dedicated to the Straumann PURE Ceramic Implant Monotype. 28 patients were treated with single tooth replacements in the frontal maxillary area according to an innovative surgical-prosthetic digital work flow fulfilling demanding esthetic requirements. The patients benefited from strict systematic clinical organization, which made it possible to focus on rationalized dental implant treatments specifically focused on the Ceramic Implant topic. Result: highly esthetic outcomes, happy patients and satisfied dentists! The post Straumann Connections 1/17: Straumann® PURE Ceramic Implant peer-to-peer surgical event in Boston appeared first on STARGET COM.


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