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Happy Hour: 1 Hour Legacy4 Immediate with CEREC Guide Case Study by: August de Oliveira, DDS

This is another simple case. I feel reluctant to post these as they are pretty old hat by now, but I know some docs have never done a CEREC Guide or an immediate molar, so if it helps one person it is worth it. I did this endo about 7 years ago and it started to get heat sensitive and throbs on its own without stimulus. I did an implant on this patient's wife and gave him the option of seeing an endodontist for a retreat, but he just wanted it done and done by me. Could I have retreated it? Sure, but CBCT revealed no MB2 and a very cylindrical root. So in these cases I really just give the option of referral to endo or extract. Patterson no longer carries the Mach 2 with powder in it, they carry the "tan" one which is no biggie as I have an omnicam. Cut the tooth down as we are sectioning anyway to make room for a large reference body.


Happy Hour: 1 Hour Legacy4 Immediate with CEREC Guide

Got my proposal from CEREC and exported it into Galileos. Lots of bone in the furcation for a 7.0mmD by 11.5mmL Legacy4 Implant Direct implant.

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Happy Hour: 1 Hour Legacy4 Immediate with CEREC Guide

Off the Mach 2 model, use your thermoplastic material. In the heated state it is translucent. Notice how I goofed! The "T" really should be palatal. Just make sure you get your drill body in there right. Scanned with "radiographic guide".

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Happy Hour: 1 Hour Legacy4 Immediate with CEREC Guide

And again, I was doing it all wrong before. Get your Drill Body from CEREC, replace the Reference body with it THEN cut your hole in the thermoplastic material.

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Happy Hour: 1 Hour Legacy4 Immediate with CEREC Guide

Cut a hole in the furcation with a surgical 557 in a surgical hand piece. Use the 2.3mm drill with my handy dandy keys. Section and remove the roots, leaving a 2.3mm glide path created with the pilot.

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Happy Hour: 1 Hour Legacy4 Immediate with CEREC Guide

The new keys are blue but you get the picture. The Large keys go up to the 5.1, so in this case you may have to use the 5.4 free hand as well as the 7mm crestal bone drill, which you have to use free hand anyway.

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Happy Hour: 1 Hour Legacy4 Immediate with CEREC Guide

Did not have any HA in my drawer so I used SBM. Use the healing abutment to tack down your membrane after grafting. I was a little more palatal than usual so I had a lot to graft on the buccal. All in all a nice smooth case.

Dr August de Oliveira graduated from dental school in 1997 from the University of Washington and completed his General Practice Residency in Los Angeles in 1998. Dr de Oliveira has been lecturing on 3D technology since 2004, when he started as a CEREC Basic trainer. Since 2008 he has been involved with Implant Direct’s R and D department developing Guided Surgery Software and Hardware and testing their CAD Milled Bars and Substructure Department. Dr de Oliveira has written two books on Implantology: Implants Made Easy and Guided Implantology Made Easy. He has been involved with beta testing Sirona’s Sidexis Program, as well as developing the Opti and CEREC Milled Surgical Guides. Dr de Oliveira lectures nationwide for Sirona on the Galileos Cone Beam system and Sirona Guided Implant Surgery. He also teaches for Implant Direct at their Las Vegas Educational Facility and with the Engel Institute in Charlotte NC. Dr de Oliveira lives and practices in Los Angeles CA.

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Happy Hour 1 Hour Legacy4 Immediate With Cerec Guide  

Happy Hour 1 Hour Legacy4 Immediate With Cerec Guide

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