GAP Australasian Dentist Sept Oct 2020

Category 60 Australasian Dentist clinical Patient medical history Patient M.P., 71 years old, male, hypertensive but was compensated by medication. The patient was using an overdenture over 4 implants and there was periodontal compromise and mobility of the three lower dental elements. Planning u Full Arch u Immediate loading Description of the procedure The tooth #33 was lost before surgery due to mobility. The surgical procedure was performed under local anaesthesia. A flap access as performed from right molar to left molar, the extraction of the #42 and #43 elements, regularization of the lower edge and drilling the implant installation sites, using a sequence of drills recommended by the manufacturer. Four jaw implants were installed using the multifunctional guide to guide the installation, all with torques above 60 Ncm. Neodent®materials Upper jaw u Neodent® Attachment Equator of 4.1 x 2 mm Lower jaw u 2 Neodent® Helix GM® Acqua™ implants of 3.75 x 16 mm u 2 Neodent® Helix GM® Long NeoPoros® implants of 4.0 x 22.5 mm u 2 Neodent® GM Angled Mini Conical Abutment 30º of 2.5 mm u 2 Neodent® GM Mini Conical Abutment straight of 3.5 mm Prosthetic description The upper implant abutments were replaced by Neodent® Attachments Equator and mini conical abutment were installed under the lower implants. Transfers were positioned and splinted with Pattern acrylic resin (GC America Inc, Alsip, USA). The impression was performed with the aid of the multifunctional guide and with the addition of silicone Express XT and the o’rings captured in the upper denture. A proof of the metal bars (made of titanium and performed by CAD / CAM) and the wax teeth were performed to evaluate its adaptation. The implant supported acrylic prostheses were installed the day after surgery and occlusal adjustments were performed. Result description/conclusion The patient returned at 1 and 4 months after surgery for preservation. The prosthesis was removed and the implants were individually tested. Refinement of occlusal adjustments and periapical radiographs was performed to evaluate the adaptation of the components. Learning outcomes from the doctor Dr. Sérgio Rocha Bernardes Professional opinion of the product and the procedure “In this case, it was possible to extract all teeth and place the implants after small bone reduction during the same surgery, making it more convenient for the patient since he had only one single surgery. The coronal bone cortex was consequently removed after bone reduction/flattening, so implant anchorage relied on the apical cortical layer. The use of Helix GM® Long implants in a case like this increases the chances of success of the immediate loading procedure, since it enhances the chances of higher primarily stability, that should be minimum 32 N.cm .” Lower Total Arch Rehabilitation with four hybrid dental implants Helix GM®Neodent® A clinical case report by Dr. Geninho Thomé and Dr. Sérgio Rocha Bernardes, Brazil Clinical case performed in collaboration with: Jean Uhlendorf, Carolina Accorsi Cartelli, Mary Stella Kivel Dias Vitório and Marcos Boaventura de Moura. Figure 3 – Try-in of the wax planning to make the surgical guide Figure 1 – Initial panoramic radiograph Figure 2 – Initial clinical aspect of the case Figure 4 – Preparation of the surgical guide