Here is a completed case that required a little fancy lasering and pink porcelain. Radiographic Guide with Barium Sulfate Teeth. Initially planned for 10-12 and 20. But thats no how things worked out.
Although I love using my CEREC for case planning, when you have more than two proposals it gets a little tough, so we went with Barium Sulfate Denture teeth in a radiographic guide.
Everything on the upper started out fine enough. I felt the pilot “pop” into #11 and at first I thought I was out the buccal plate, but it turned out it was an immature graft.
Go into 10-12 and where the area was grafted it was just moosh. Some weird type of synthetic graft that I could scrape out. Note the appearance in the cross sectional view and you can see in the flap on my periosteal elevator how it turned out.
Ended up placing Implants in the 10 and 12 positions and grafting around the implant with a membrane after MFDBA.
#20 went nice and smooth without any complications. Did a Classic Guide on the upper as we had Barium sulfate teeth, but with the same scan, did a lower optiguide.
Pretty simple, you can see a lot of punched up tissue in the yellow outline of the CEREC scan.
4 months later the patient returns and everything looks good on the pan. He has a number of perio issues and sees a periodontist back home.
The graft healed very well. Excellent torque values on the teeth. Note the density of the graft.
Used my Sirolase to uncover the healing caps. One cool trick is to replace the surgical guide to help you find the implants and avoid losing tissue by lasering in the wrong area.
I love how fast punches are. But using the laser really makes your life easier while doing fixture level impressions.
I told the lab to use some pink porcelain, they ended up also using it on #20. Not necessary but cool anyway.
The patient returned a few weeks later. Note the healed tissue after the layering. Torqued the abutments at 30 Ncm
Here is the finals. I know it still has that “hunk of bubblegum” look, but when the patient’s smiles normally you can’t even tell.