Have you ever remodeled an old house? It starts like this: “Lets remodel the bath room”, then “Lets just paint the walls”, then explodes into demolishing the whole house and starting over. This case reminds me of that, just with more headaches. Patient originally came in with pain on an existing bridge from 3-5. Removed the bridge free handed #4 and grafted #3 just to get him into a temp with a cantilever on #3 as this patient did not want to be without a tooth. After placing the implant on #3 the patient decided he wanted to redo his front bridge with an implant, so we did that as well:
Radiographic Guides made, Drill bodies in CEREC:
If you are having problems in with CEREC Guide a great way to test is to simply drill on a model before you work on a patient. If you are extra anal, you can place an angulation pin, powder it up, and import it back into Galileos as an .ssi file. In the LR image you can see the outline of the pin perfectly following the pilot drill path.
In the mouth, in the LR I show that you need to adjust the Thermoplast with an acrylic bur so that the hand piece can get to the Drill Body. If the yellow is too high you can’t get to length.
Implants placed, I replaced the old yucky buildup on #5 you can see it in the next slide:
Got the Patient into Biotemps off a diagnostic wax up that the patient liked. The problem was that after the temps, the patient then wanted to redo the bridge on the other side. Then when we did those temps, the patient decided that they wanted to show more incisor, and wanted the bite opened. Then after those temps, they wanted more bite opening, then more, then more. God help me.
Because the anterior implant was placed at a different time that the posterior and was not planned when we did the posterior it gave me a chance to check the placement of #3 with the plan.
Finals, yes they are white. Yes they are long. Thats how the patient wanted them. #9 is an Implant, as is #4 and #3 (sorry reversed image on the occlusion shot), now the patient wants to do they lowers, Angel of Death take me now ;}