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CASE PRESENTATION: Overdenture Implant Placement Using a 3D-Printed Surgical Guide

Categories: Implant Dentistry

Author(s): Michael David Scherer

Date: 07-15-2020 08:58:55 am

A healthy, 70-year-old woman presented with a loose mandibular complete denture, complaining that she was unable to chew hard and crunchy foods. She requested minimally invasive narrow diameter implants to stabilize her denture. Her mandible edentulous ridge had
adequate bone volume to allow for flapless implant placement (Figures 1 and 2).

A radiopaque PVS (Green-Mousse, Parkell) was applied to the intaglio of the mandibular complete denture, and the patient and denture were CBCT scanned using the PreXion3D Eclipse (PreXion). Cotton rolls were used to aid in occlusal and soft- tissue separation.

Using Blue Sky Plan (Blue Sky Bio) dental implant planning software, I opened the DICOM files to be- gin digitally planning the patient’s treatment. Her treatment included four 2.9 mm x 12 mm LOCA-  TOR Overdenture Implants (Zest Dental Solutions) (Figure 3). A surgical guide incorporating these im- plants was designed and exported into a 3D print- able file. I printed the guide design file on Dental   SG biocompatible surgical guide material using the Form 2 3D printer, both from Formlabs (Figure 4).

The osteotomy was prepared through the 3D printed surgical guide using the drill stop as an indicator. After the guide was removed, the remaining osteotomies were prepared freehand. Four implants were placed using a minimally inva- sive technique, and fully inserted using a torque wrench (Figures 5–8). The LOCATOR abutments were placed onto each implant and torqued to 30 Ncm (Figure 9). The patient’s bone density was ideal, which resulted in a high insertion torque (Figure 10). Recesses in the denture were prepared using acrylic burs from the Denture Prep & Polish Kit (Zest Dental Solutions) (Figure 11).

Because the patient preferred not to immediately attach the implants, CHAIRISIDE Soft Reline Material (Zest Dental Solutions) was injected into the intaglio of the denture and placed onto the edentulous ridge. After complete polymerization, the denture was removed, trimmed, and inserted back onto the ridge (Figure 12). The patient returned 3 months after treatment to receive final prosthetic procedures.

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