Less complex: Fixed edentulous treatment procedures with Straumann components

Images courtesy of Dr. Runyon and Dr. Ralstin, Lab work by Darrel Clark, CDT, Fort Worth, Texas, USA

Initial situation: A female patient presented at the dental office with a problematic screw-retained bridge restoration in the anterior maxilla. Based on her dental history it was decided to go for a fixed restoration on 4 implants and an immediate temporary prosthesis.

  • Pre-operative situation
  • Study model, surgical stent and interim fixed bridge prepared by the dental lab
  • Anterior maxilla occlusal view
  • Flap and extraction of maxillary teeth
  • Straumann® BL RC Implant with SLActive® surface placed at #24 after bone ridge reduction
  • Screw-retained Abutment, 30° angled, placed onto the implant
  • Titanium Temporary Copings, non-engaging, placed intra-orally, facial view
  • Block-out technique to protect screw channels of the Temporary Copings, surgical stent used to verify position of abutments and Occlusal-Screw channel
  • Blu-Mousse® application to identify the emergence of the Temporary Copings as well as preparation for pick up
  • Trimming of impression material in the dental lab, the holes on the study model now represent the implant positions
  • Study model drilling and registration
  • Interim fixed bridge registration with study model
  • After trimming, fixed bridge prepared for intra-oral pick up as well as check of passivity and fit on study model
  • Screw channels of Temporary Copings blocked out, access and passivity in the patient’s mouth verified
  • Acrylic-material intra-oral pick up
  • After trimming of fixed bridge, another fit check of study model
  • Interim fixed bridge, post-operative, facial view: note buccal flange extension, adaptation to maxillary ridge, and relation to mandibular natural dentition
  • For the final fixed bridge, Straumann® CARES® Bars are used as a framework
  • 4 months later, the final fixed bridge is delivered to the patient
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Blu-Mousse® is a registered trademark of Parkell, Inc, USA.

Immediate implant-supported full-arch reconstruction of both jaws

Images courtesy of Dr. Sergio Piano, dental surgeon and prosthodontist, Genoa, Italy

Initial situation: An 80-year male patient in good physical health, required fixed rehabilitation in both jaws to replace an existing unsuitable upper denture and to restore the hopeless dentition in his lower jaw (Fig. 1). When the patient smiled, his upper teeth were barely visible and the protrusion of his upper lip was deemed too full from an esthetic point of view.
Due to gingival recession and periodontal disease, his lower incisors were excessively visible. A removeable prosthesis in the mandible had never been tolerated by the patient due to his gag-reflex. Therefore, the patient requested to receive treatment in both jaws at the same time, in order to avoid using any provisional removeable prostheses and to shorten the overall treatment time. The aim was to perform both implant placement and loading with screw-retained provisional prostheses in both jaws on the same day.

A special thanks to Alessandro Giacometti for his precious help in lab procedures.

  • Extraoral situation before rehabilitation
  • The intraoral view shows the situation before the rehabilitation
  • Check an ideal set-up in the patient’s mouth
  • For the upper jaw, the CBCT exam revealed a very poor bone quality in the sites chosen for implant positioning, hence Bone Level Tapered Implants were selected to increase primary stability and to facilitate immediate loading
  • For the upper jaw, the diagnostic guide was made into a surgical guide. For the lower jaw, a surgical guide (for computer-guided surgery) was produced
  • Firstly, the lower jaw was treated by placing implants with a guided-surgery procedure
  • After positioning the implant, the Screw-retained Abutments were chosen and then placed on the implants
  • The lower provisional prosthesis was then placed on the implants, connecting them to the copings positioned in an occlusion with the upper surgical guide
  • Secondly, the upper jaw was treated. The first implant site was prepared using dedicated drills for Bone Level Tapered Implants
  • Faced with a low quality bone (Type 1), the site was under-prepared and Bone Level Tapered Implants were placed in order to reach the required high implant stability
  • The appropriate Screw-retained Abutments were chosen using the corresponding Planning Kit
  • After the completed healing process, healthy soft tissue could be seen around the implants of the upper jaw
  • The lower jaw shows an excellent soft tissue condition as well
  • The impression procedure: for the upper jaw, transfer copings were used: for the lower jaw, titanium copings were used
  • CAD/CAM framework by Createch, later veneered using a composite resin
  • The rehabilitation satisfies both, esthetic and functional criteria
  • Final x-rays demonstrate a correct implant placement and a very precise prosthetic rehabilitation

Createch may not be available in all countries