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Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide Case Study by: August de Oliveira, DDS

Sorry I haven't posted in a bit. Lots of projects and life happening at once. Here is a really hard case that I think turned out OK in the end. Patient had a very large edentulous space around #22 with the previous canine tipping distally. Suggested an implant and went to work.


Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide

#21 really kicks its apex to the mesial, but we do have a lot of bone.

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Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide

Constructed CEREC Guide. As I have said in previous posts, the worst thing you can do is cut the thermoplastic without the drill body inserted. So put the drill body in then cut your hole. Used my last of the white Mach 2, Patterson now just carries the tan, which is fine as I don't need the powder.

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Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide

Placed my drill body and then cut my hole. Make sure it is flush with the base.

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Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide

Ok the keys are in, in case you have not seen them. Just go to the IME shop at http://www.implantsmadeeasy.com/shop/. Also, I have two sets of periotomes and 3 sets of implant instruments I need to put up, including the really cool grafting instruments. I have some punches but I need to go back to the drawing board on those.

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Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide

In the mouth everything seemed to be going OK. Tissue got a bit beat up in the extraction. Turns out, removing canines wasn't as easy as I thought. ď Š

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Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide

Here is the final placement with a Legacy4. I was a little concerned with the spacing between #21 and the implant so I took a scan and we are lingual and at least 1.5mm away. Whew! Immediate temp and will wait 3 months.

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Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide

Turns out the patient was tired of her lowers, so we removed the veneers which helped a bit in the spacing.

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Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide

My lab, Level 3 with Jack did a great job in InLab managing some tough spacing!

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Una-Tooth: Large Edentulous Space with Legacy4 and CEREC Guide

Final with screw retained Emax. Not the most ideal case, but I think we managed to get the spacing right in the end.

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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Una-Tooth: Large Edentulous Space With Legacy And CEREC Guide  

Una-Tooth: Large Edentulous Space With Legacy And CEREC Guide

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