Page 1

Thank You Sir, Can I Have Another? Yet another Immediate Legacy Molar CEREC Guide Case Case Study by: August de Oliveira, DDS

Ok, so my Portuguese brother Dr. Lou Paulerio told me to keep posting simple CEREC Guide cases, here is another one! Non-restorable #14, good bone in the furcation. Fabricated the radiographic guide with the reference body. Scanned the tooth in CEREC for the .ssi file.


Thank You Sir, Can I Have Another? Yet another Immediate Legacy Molar CEREC Guide Case

When I am designing the CEREC crown form I look out for two things, central fissure position and cusp position. If I want to go screw retained, I really want that screw access to be right in the center of the tooth. (Spoiler Alert: I didn't end up there, but at least I tried)

2|P a ge


Thank You Sir, Can I Have Another? Yet another Immediate Legacy Molar CEREC Guide Case

Again, you know my deal. Drill a hole through the furcation with a surgical carbide. Drill through the furcation with a 2.3mm pilot, get your glide path then section and remove the roots with luxators. Then replace the CEREC Guide and finish the osteotomy.

3|P a ge


Thank You Sir, Can I Have Another? Yet another Immediate Legacy Molar CEREC Guide Case

Nice 7.0mmD by 11.5mmL HA-Coated Legacy2. Why not the Legacy3 or 4? I don't need or want the stock abutment as I am going with a custom Emax as my final. Not in love with the final position of the implant, I am a little too distal with the screw access. The problem with all immediates is that you really are hanging on with a little bone and although it does grip the apex, the platform is sometimes free to deviate.

4|P a ge


Thank You Sir, Can I Have Another? Yet another Immediate Legacy Molar CEREC Guide Case

Also, by now you know my deal with grafting. Leave the Legacy2 mount on and pack some DFDBA around it. Make a hole in your membrane and pass your healing abutment through that hole so that you can skew down the membrane. I am really not in love with my placement. I could have had my apex more distal and my platform angled a bit more medial as my screw access will now be in the distal half of my crown leaving a mesial cantilever. I am a little close to the pre-molar. No bueno! I may end up with a separate custom abutment and crown just to hide that! Oh well, the more I place implants the more I am craving finding a fully guided system especially in immediates.

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.

5|P a ge

Thank You Sir, Can I Have Another Yet Another Immediate Legacy Molar Cerec Guide Case  

Thank You Sir, Can I Have Another Yet Another Immediate Legacy Molar Cerec Guide Case

Read more
Read more
Similar to
Popular now
Just for you