Digital planning and guided surgery in oral rehabilitation

a case report

Authors

  • Larissa Braga dos Santos Pontifícia Universidade Católica PUC- Rio
  • Adriano Relvas Barreira de Oliveira Pontifícia Universidade Católica PUC - Rio
  • Mauro Lefrançois Pontifícia Universidade Católica PUC - Rio
  • Marcos Venício Azevedo Pontifícia Universidade Católica PUC - Rio
  • Pablo Sotelo Pontifícia Universidade Católica PUC - Rio
  • Laura Sotelo Pontifícia Universidade Católica PUC - Rio

DOI:

https://doi.org/10.11606/issn.2357-8041.clrd.2020.172078

Keywords:

Digital Planning, Guided Surgery, Zirconia, CAD/CAM

Abstract

Digital planning of the prosthesis associated with surgical planning increased predictability, since surgical guides indicate the best place for implant installation, thus reducing the number of complications, and the CAD/CAM system provides predictability in the preparation of final restorations, according to the procedure previously planned. Our study reported a digital workflow used for the guided installation of two dental implants in regions 14 and 16, extraction of tooth 15 and installation of a fixed prothesis over implants. After anamnesis and clinical evaluation, intra- and extra-oral photographs of the patient were performed, molding the upper arch with polyvinylsiloxane (2-step putty/light-body technique) and requesting computed tomography. The plaster model obtained was sent to the laboratory and scanned. The generated file (STL) was used to create a diagnostic wax-up that was aligned to the tomography (in DICOM format), enabling the three-dimensional planning of the implants, which generated a partial printed surgical guide after approval of the dentist. After six months, the patient received the provisional fixed prosthesis printed in PMMA (polymethylmethacrylate) on an intermediate in PEEK (polyetheretherketone) aiming to condition an emergency profile to receive a definitive prosthesis two months later, with zirconia-milled infrastructure on a ti-base. The correct understanding of the operator about the steps of the digital workflow (diagnosis, prosthetic planning, surgical planning, guide preparation, temporary and final restorations) gives the operator improved predictability at the time of surgery as well as satisfactory aesthetic and functional result of definitive restorations.

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Author Biographies

Larissa Braga dos Santos, Pontifícia Universidade Católica PUC- Rio

DDS, graduate student, School of Dentistry, Department of Prosthodontics, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, RJ, Brazil

Adriano Relvas Barreira de Oliveira, Pontifícia Universidade Católica PUC - Rio

DDS, MSc, Associate Professor, School of Dentistry, Department of Prosthodontics, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, RJ, Brazil

Mauro Lefrançois, Pontifícia Universidade Católica PUC - Rio

DDS, Associate Professor, School of Dentistry, Department of Prosthodontics, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, RJ, Brazil

Marcos Venício Azevedo, Pontifícia Universidade Católica PUC - Rio

DDS, Associate Professor, School of Dentistry, Department of Prosthodontics, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, RJ, Brazil

Pablo Sotelo, Pontifícia Universidade Católica PUC - Rio

DDS, MSc, Associate Professor, School of Dentistry, Department of Prosthodontics, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, RJ, Brazil

Laura Sotelo, Pontifícia Universidade Católica PUC - Rio

DDS, MSc, PhD. Associate Professor, School of Dentistry, Department of Prosthodontics, Pontifícia Universidade Católica (PUC-Rio), Rio de Janeiro, RJ, Brazil

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Published

2020-09-24

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Section

Case report or technical report