Page 1

Vanilla Ice: "White Metal" Legacy3 case with CEREC Guide Immediate Case Study by: August de Oliveira, DDS

Here is an everyday case that we face as GPs. Patient breaks off a lateral, going on a vacation soon and has to look great. We really did the whole "tag team" thing here, starting in CEREC for the ssi, back to Galileos, then CEREC again for the CEREC Guide and finally the CEREC "temp". Now one issue I have, being quite snobbish these days with custom abutments, is that I need an abutment to temporize. Yes, I could do it with the Emax blocks, but that does take a lot of time and you do have to burn out the ti base, which I have heard from a few is tough. There is a product called "White Metal" from Blue Sky Bio, which is a titanium opaquer. So I gave it a go and I must say, it’s quite awesome!


Vanilla Ice: "White Metal" Legacy3 case with CEREC Guide Immediate

I planned the case in Galileos. One thing I love to do is turn off the model and check my implant relative to the crown. We know our math, right? 3-4mm below the CEJ for emergence profile but no further than 5mm to grow a papilla. Note also the pilot drill path which estimates where the screw access would go if this was a screw retained crown, so we know we will need an abutment and crown.

2|P a ge


Vanilla Ice: "White Metal" Legacy3 case with CEREC Guide Immediate

While CEREC was milling my guide, I removed the root with my IME Luxator kit and surgical kit. Should get some more soon, I know I have gotten a lot of requests.

3|P a ge


Vanilla Ice: "White Metal" Legacy3 case with CEREC Guide Immediate

Tight space, but I still used a 3.7mmD by 16mmL Legacy3 implant. The 3.2mmD would not have the stability I needed. Note the fixture mount is an abutment and this patient has a high smile line and is esthetically conscious. Plus is going on a vacation, so I needed to make a great temp, and cement it permanently.

4|P a ge


Vanilla Ice: "White Metal" Legacy3 case with CEREC Guide Immediate

But what to do? Titanium is ugly and would certainly show through her thin tissue. So I tried out the White Metal from Blue Sky (www.blueskybio.com). First, you cut the top off the Legacy3 mount (if using the Legacy4 you would just pop it off). Sand blast after trying in the mouth. She had a deep bite, but I still did not have to prep. Then use a light cured primer.

5|P a ge


Vanilla Ice: "White Metal" Legacy3 case with CEREC Guide Immediate

Apply the opaquer to just above the abutment margin. Scanned in CEREC and milled a B1 Empress CAD Multi "temp". I use Emax for my day to day stuff and still have a ton of Empress in my drawer so I like these instead of dealing with the big 'ol Telio CAD block. But look at how well it’s masked!! In the past, I would use a stock Zirc abutment for my temp then chuck it and went with a custom abutment for my final. Not any more, I can save at least $120 per case using the stock abutment from Implant Direct! Cemented with Multi-Link and will just prep it off at 6 months.

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.

6|P a ge

Vanilla Ice:"White Metal" Legacy3 case with CEREC Guide Immediate  

Vanilla Ice:"White Metal" Legacy3 case with CEREC Guide Immediate

Read more
Read more
Similar to
Popular now
Just for you