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Stretching the Envelope—Made Possible by Guided Implant Surgery
Achieving highly accurate implant placement into an expanded ridge
A 58-year-old man was referred by his general dentist for replacement of a failing fixed bridge from teeth Nos. 7 through 10. Both abutment teeth showed decay, and radiographically, tooth No. 10 had an apical radiolucency and widened periodontal ligament space. The treatment plan comprised removal of the abutment teeth and restoration with individual implant-supported fixed prostheses for each missing tooth. His existing provisional prosthesis was used to determine the optimal position and orientation of the implant fixtures. A GALILEOS cone-beam computed tomography (CBCT) (Dentsply Sirona, www.dentsplysirona.com) scan demonstrated adequate bone height; however, deficient crestal bone width in the sites necessitated prosthetically based implant placement. After determining radiographically that the basal bone was sufficient to achieve initial primary stability, it was planned to surgically expand the ridge width simultaneously with removal of the failing teeth and placement of four dental implants.
• Ideal implant positioning, angulation, and depth were determined by merging CAD/CAM and CBCT data and following the concepts of prosthetically driven implant planning.
• A GALILEOS implant surgical plan was used to design the guided surgery protocol used for osteotomy preparation and implant placement, specifying drill guides, lengths, and diameters, implant drivers, and depth positions to enable exact replication of the surgical plan in the patient.
• GALILEOS guided implant surgery facilitated extremely accurate implant placement into the expanded ridge.
About the Authors
Jay B. Reznick, DMD, MD
Southern California Center for Oral and Facial Surgery
Diplomate, American Board of Oral and Maxillofacial Surgery