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Case report Dr. Dov Kischinovsky Jerusalem - Israel


Preoperative Panorex With radiopaque ScannoGuide


Diagnosis:Female,54 y Main complaint: Upper edentulous left area Medical History: IHD Diabetes Mellitus Treatment plan: . Unilateral Pterygoid implant positioned with Tooth27 Mucosa-Supported SurgiGuide

Standard Implants 24 25 Permanent bridge 24 25 27


Pre-treatment CT scan


To plan Conversion of the CT data to 3D file: Surgery planning with SimPlant速

SurgiGuide速 type

SurgiGuide速 solution

Immediate loading

Temporary prosthesis

Final prosthesis

Navigator SurgiGuide速

NO

No

Bridge


Simplant Panoramic View choosing preferred cross section plane


3D Lateral image with planned bridge (pink) and implants


3D Lateral image with planned bridge (pink) and implants


Axial view with pterygoid(Zygoma) implant head on alveolar ridge

. One-stage placed implants


Axial view


To plan


To plan


Modification from zygomatic implant position to posterior pterygoid position


To plan


Sagittal view


To plan


To plan


To Surgiguide


To Surgiguide -

Plaster Model


SurgiGuide for Pterygoid placed Zygomatic Implant


Surgiguide for Biomet 3i Implants


To guide – Visualisation using plaster model


– Showing Zygoma Implant with angulated head and angulated abutment


Pre-operative


Drilling with long drill through SurgiGuide with pterygoid(Zygoma) implant: 10mm high metal sleeve.


Angulated 45 degree of head of pterygoid(zygomatic )implant demonstrating parallelism of abutment to implants placed anteriolly

AAAAa


Clinical Photograph of surgery – One stage Healing Abutments


To guide Clinical Photograph of surgery – tooth 37


Clinical Photograph Multi-unit Abutment on Implant 27


Photograph of Prosthetic Restoration (Dr.Moshe Kaplan,Jerusalem

)


To guide Clinical Photograph of surgery – tooth 37


Postoperative bridge


Virtual planning versus Post-operative stage


Final bridgework


Conclusion This new modification of the zygomatic implant technique ,where the pterygoid placed implant emerges on the dento-alveolar crest makes it an excellent support for prosthetic work.By the use of a drill guide the implant is placed in exact position without raising a mucosal flap reducing operation time and morbidiy,as an alternative to sinus augmentation.

unilateral zygoma implant in pterygoid area  

Long iomplants as alternative to sinus augmentation