Case Studies

Case Presentations which quickly get to the point. They show the problem and then get right into how the case was treated. Critical principles are outlined. You can see what materials were used and how the case turned out.

Custom impression procedure

By Dr. Peter Hunt

When a nice emergence profile has been worked out in the Provisional Restoration, it's useful to carry that over to the final restoration. One technique is shown here. The abutment is removed, an implant analog is attached, then the assemblage is placed down into a small cup containing impression material. When this is set, the abutment is removed and an impression device is attached. Flowable resin or acrylic is placed down into the crevice between the impression material and the impression device. When cured, the retaining screw is unscrewed and the assemblage withdrawn. This "Custom Impression Device" is then able to be placed into the mouth to be picked up in an over-impression.

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From Ridge to Bridge: Part 1

By Laura Ceccacci

It's common enough, a removable partial denture destroys the adjacent natural teeth. In this case it is the maxillary incisors that are suffering. The patient wants something more stable, healthy and aesthetic. This is supplied by a digital driven approach where a Surgical Guide, Zirconia Emergence Abutments and a Provisional bridge are prepared before the procedure. See also the second part of this presentation (From Ridge to Bridge : Part 2 - Clinical procedure).

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From Ridge to Bridge: Part 2

By Dr. Peter Hunt

This is a follow-up from Ridge to Bridge Part 1. This shows how the clinical procedure goes. She has the two lateral incisors removed, implants are placed using a Surgical guide. Then it's possible to insert some provisional zirconia emergence abutments and a provisional bridge. The partial denture is thrown away and the patient is delighted.

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Replacement of a central incisor with considerable infection

By Dr. Peter Hunt

A maxillary central incisor is hopeless, and there is a great deal of infection and granulation tissue present in the region. Great care must be taken to remove all of this. Fortunately there is adequate remaining bone to stabilize an implant. With a Zirconia emergence abutment and provisional crown it's possible to make her look whole again.

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Failing maxillary section

By Dr. Peter Hunt

A three-unit bridge in the maxillary posterior region is failing because the terminal molar has a major tri-furcation abscess. The patient is a high-powered executive who would not tolerate a gap or a partial denture. The answer is to remove the two teeth supporting the bridge and to place three implants. One, in the molar region is not able to be loaded Immediately. Another implant is placed in the edentulous part of the ridge and a final one immediately replacing the first premolar. These two anterior implants are immediately restored with zirconia emergence abutments and a splinted plastic provisional bridge. He managed fine with this arrangement. After healing, three individual restorations were placed on these implants.

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Guided immediate replacement of two mandibular molars

By Dr. Peter Hunt

Two mandibular molars are in a bad way and the support for the second premolar is jeopardized. The solution is to remove the two molars, to clean out the region, and then immediately to place two implants. The key to success though is to extensively regenerate in the region at the same time. Healing went well and the patient was spared from having three missing teeth and a collapsing mandibular ridge,

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Implant therapy in a maxillary posterior segment

By Dr. Peter Hunt

A maxillary molar is failing and the quadrant will then have no molars and only one premolar remaining. The solution is to remove the failing molar and to place an implant immediately with a sinus lift and socket augmentation at the same time. In the edentulous premolar space further forwards another implant was placed. Later, these implants can both be restored with individual restorations.

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Management of a failing maxillary posterior segment

By Dr. Peter Hunt

There's lots going wrong on this patient. There is a failing implant, a molar with a deep mesial periodontal defect and a premolar with a furcation problem. Removing the implant is simple enough but the region needs a very through degranulation, the molar periodontal defect is managed at the same time. There is an edentulous region between the molar and the implant socket where an implant can be parked. The first premolar has spindly roots which break off quite easily. Once the roots are removed, an implant can be placed there as well. With extensive regeneration in the whole region a good result can be anticipated.

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