Canada (EN)
CLINICAL CASE
Clinical applications of TiUltra™ implants and Xeal™ abutments in full-arch and individual restorations
Dr. Nader Salib
Patient: 73-year-old, male
Clinical situation: Currently retired. Previous fixed bridge work failing. Patient is very esthetically conscious and desired a fixed, immediate, graftless solution for his maxilla and replacement of 3 missing mandibular teeth.
Surgical solution: Remaining teeth were extracted and infection cleared. 6 maxillary implants (NobelActive® TiUltra™) and 3 mandibular implants (NobelParallel™ CC TiUltra™) were placed. A temporary fixed prosthesis was delivered the same day.
Restorative solution: A fixed ceramic prosthesis was made for the maxillary arch, seated on Multi-unit Abutments Xeal, and screw retained abutment/crowns were fabricated for the mandibular teeth.
Surgery date: December 1, 2020
Total treatment time: 4.5 months
Tooth position: Full maxillary arch; #36, #45, #46.
Initial clinical situation
Maxillary arch: Multiple decayed, non-restorable teeth. Multiple abscesses in bone. Mandibular arch: Multiple missing teeth.
CBCT: Pano view illustrating clinical situation (left).
Photo showing multiple decayed teeth (right).
CBCT: Pano view maxillary arch (left).
Intraoral photos demonstrating oral health (right).
Treatment planning
Digital treatment planning with DTX Studio™ Implant software.
CBCT (left).
CBCT and patient’s intraoral scan (center)
Final plan with implants and template shown (right).
Digital treatment planning with DTX Studio Implant software.
CBCT (first image from left).
CBCT and intraoral scan (second image from left).
CBCT, intraoral scan and teeth mockup (second image from right).
Final plan with implants and template shown (first image from right).
Mandibular arch: 3D view of proposed implant placement with DTX Studio Implant software.
3D view: All implants planned for screw-retained restorations with access through central fossa.
Mandibular arch: Sagittal view of proposed implant placement (NobelParallel CC TiUltra).
#46 (left), #45 (center), #36 (right).
Surgical procedure
Planning to execution.
Maxillary and mandibular templates shown respectively (left).
PO Pano X-ray demonstrating implant placement (right).
Maxillary ridge reduction and implant placement.
Mandibular implant placement. Surgical placement of NobelParallel CC TiUltra implant.
Surgical outcome
Mandibular implant evaluation.
Intraoperative photo of NobelParallel CC TiUltra implant placement (left).
4-month PO check – maxillary treatment (center and right).
4-month PO check – maxillary treatment.
Intraoperative: Xeal Multi-unit Abutment placement (left).
4-month PO evaluation and integration check demonstrating gingival health around Multi-unit Abutments with Xeal surface (right).
4-month PO check – maxillary treatment.
Before: Preoperative photo demonstrating gingival health (left).
After: 4-month PO evaluation and integration check demonstrating healthy well healed soft tissue around the Multi-unit Abutments with Xeal surface (right).
Temporary prosthesis
Temporary restorative work performed in collaboration with Dr. Dave Eggleston, prosthodontist.
Before treatment (left).
After treatment (right).
Final prosthesis
Final restorative work performed in collaboration with Dr. Dave Eggleston, prosthodontist.
Before treatment (left).
After treatment (right).
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