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The complete digital  implant workflow

















          Clinical case report
          The clinical case illustrates the
          advantages of using Planmeca CAD/                                                   4
          CAM solutions in the digital planning                           3
          of an implant placement and surgical
          guide as well as in the fabrication of a   Fig. 3. & 4. Digital implant and surgical guide planning in the Planmeca Romexis®
                                                software.
          ceramic restoration. This article presents
          a clinical case in which the treatment
          was completed using the Planmeca
          Romexis® 3D Implant Guide software,
          Planmeca PlanCAD® Premium                                        Fig. 5. Surgical guide was fabricated for
          software and Planmeca PlanMill® 40                               maximum precision
          milling unit.
            The clinical case features a female
          patient, who complained about missing              5
          tooth 2.2 as well as the shield-like
          shape of tooth 1.2 (Fig. 1–2). During
          the initial examination, the area around
          the missing tooth was estimated
          quite narrow for an implant. However,
          the patient declined orthodontic
          preparation, as she had already
          previously had orthodontic treatment
          with orthodontic surgery.
            In this particular case, we started
          with an aesthetic analysis of the
          patient’s CBCT data and concluded that             6                                7
          a Straumann implant with a 2.9 mm
          diameter would fit in the area of tooth
          2.2, if we used a surgical guide for   Fig. 6. & 7. Successful placement of the implant
          maximum precision (Fig. 3–5). For tooth
          1.2, we decided to fabricate a thin-walled
          IPS e.max ceramic restoration.
            Thanks to digital planning and a
          carefully fabricated surgical guide, the
          implant was placed successfully even
          though the anatomical conditions
          appeared to be less than advantageous.
          We achieved a torque of 30 N/cm and
          attached a healing abutment to the
          implant (Fig. 6–7).
            Three months after the
          implant placement operation, the
          osseointegration of the implant fixture
          was completed. A temporary crown
          was fabricated on the implant from                    8                  9               10
          a VITA ENAMIC multiColor block to
          support the formation of soft tissues   Fig. 8.–11. Temporary crown was installed to support the formation of soft
          (Fig. 8–10). We improved the original   tissues.



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