Bi-maxillary full-arch edentulous restoration with immediate loading using X-Guide® navigated surgery, and X-Act Teeth pre-fabricated provisional technique
Dr. Renaud Noharet
France
Initial situation (left).
Pre-op orthopantomogram (OPG) (right).
Pre-op bite frontal view (left).
Pre-op maxilla frontal view (top right).
Pre-op mandible frontal view (bottom right).
DICOM (left), PLY scan (center), clinical pictures (right).
Merging DICOM and PLY files (left).
Merging DICOM and PLY with intraoral images (center).
Cross section alignment between DICOM & PLY scan (right).
Pre-op maxillary PLY scan (top left). Prosthetic wax-up STL of maxilla shared by the dental lab (bottom left).
Prosthetic wax-up merged with initial intraoral situation (center).
Pre-op mandibular PLY scan (top right). Prosthetic wax-up STL of mandible shared by the dental lab (bottom right).
Frontal view of N1 implants 4 x 13 mm planned in maxilla (left).
Occlusal view of N1 implants 4 x 13 mm planned in maxilla (right).
Frontal view of N1 implants 4 x 13 mm planned in mandible with Multi-unit Abutment (left).
Occlusal view of N1 implants 4 x 13 mm planned in mandible with Multi-unit Abutment (right).
Frontal view of prosthetic wax-up with 4 insertion bone pins ready for printing before surgery (left).
Occlusal view of prosthetic wax-up with 4 insertion bone pins ready for printing before surgery (center).
Intaglio surface view of prosthetic wax-up with 4 insertion bone pins ready for printing before surgery (right).
Import of prosthetic wax-up in DTX Studio Implant for referencing the insertion bone landing pins (left).
Cross section of the bone landing pins (1), followed by implant placement selection to define both depth and diameter (2) (center).
All bone pins defined as implants in the implant planning project before exporting the treatment plan into X-Guide for surgical execution (right).
Fixing X-Guide tracker with EDX screws in the patient’s upper jaw to prepare for X-Mark protocol* (left).
Calibration following X-Mark protocol (identification of clear reference points to calibrate accuracy of X-Guide (right).
Extraction, immediate implant placement and Multi-unit Abutment placed in the maxilla. Additional osteotomies were performed to host the defined landing pins, allowing predictable prosthesis positioning (left).
Extraction, immediate implant placement, and Multi-unit Abutment placed in the mandible (right).
PMMA milled provisional for maxilla (left).
PMMA milled provisional for mandible (right).
Maxilla. Pre-fabricated temporary seated on top of temporary Multi-unit Abutment – ready for conversion. Composite flow must be injected within residual hole area to consolidate temporary Multi Unit Abutments and the corresponding provisional (left).
Mandible. Pre-fabricated temporary seated on top of temporary Multi-unit Abutment – ready for conversion(right).
Provisionals post-conversion (landing pins removed post-conversion) (right).
Provisionals placed 4 hours after surgery (left).
Provisional at 4 months follow-up (left).
X-Ray at 4 months follow-up (right).
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Nobel Biocare N1™ systemChange the way you treat patients.
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X-Guide®Free-hand surgery with a real-time 3D guidance of your drill.
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All-on-4® digital workflowA flexible digital solution for full-arch rehabilitation.
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