Clinical case: Final molar in one day
In this clinical case, Dr Bobby Birdi demonstrates the innovative On1 concept and the benefits of a fully digital workflow.
Single molar tooth replacement is still the hallmark of dental implantology today, and this may continue for many years to come. As a result, numerous implant designs and various restorative solutions have come and gone through the evolution of this type of treatment. Implant therapy in the molar region has benefited from advances in surgical innovation, implant and restorative design, as well as the use of digital technology in treatment planning. This use of digital technology in implant therapy has elevated the precision and predictability of treatment. Nonetheless, it is only the execution of the therapy that has been enhanced overall, and rarely the total treatment time. Even with the use of digital dentistry, the process of molar implant therapy has remained consistent for years. This most often involves implant placement after tooth removal, followed by three to six months of healing, and then an impression (digital or analog), and finally the placement of the final lab-fabricated restoration a few weeks thereafter. Immediate loading of implants in the molar region is not commonly implemented, and even when undertaken, almost always involves the use of a provisional restoration.
However, with the use of digital technology in treatment planning, restorative design, and the execution of computer guided implant surgery it may now be possible to fully synergize surgical and prosthetic aspects of molar implant therapy and truly realize the time benefits that can be offered. This process is started by acquiring and using both CBCT and digital impression technologies. With this digital information, the 3-dimensional location of the final restoration can be completely designed first, and then the surgical anatomy can be properly assessed to precisely and predictably plan the most ideal implant position that will support the final crown. The final screw-retained molar crown may then be fabricated in advance.
This report will describe a clinical case that involves the delivery of a new innovative final pre-fabricated screw-retained implant restoration on the day of implant placement with a one-year follow-up. The benefits of a fully digital workflow will be showcased.