DENTAL TECHNOLOGY
ALL ON 4
WORKFLOW By Matteo Neroni
A
fter several years of research and development in the type of total prosthetic rehabilitation on implants, it has been established that one rehabilitation done on 4 or more implants is amongst the safest and long-lasting rehabilitations existing on the market today.
Fig. 1
Fig. 2
The fundamental basis of this rehabilitative procedure is planning by means of photographs and RX
Fig. 3
In this first step, an AO4 example of the Mascellar Superior, the dentist alongside his/her dental technician will evaluate the possibility of a bone reduction. This type of evaluation is done by overlaying multiple images of the patient with a frontal photograph of the rx, with which one is able to plan where the new transient line can be found in an extremely accurate way after bone reduction, always being when the patient smiles showing the gum in an excessive way. (Fig.1)
Fig. 4
At this point, facial planning begins. (Fig.2) After the planned bone reduction, the patient's new smile is virtually designed, respecting the golden proportions, the correct curves, and masticatory functions (fig.3) After surgery and correct planning, both aesthetic and functional, this is an example of the post-operative AO4 where the perfect symmetry and accuracy is shown, in the position of the implants, which the clinician is able to do with this type of planning; in this specific case in FreeHand (fig.4) This type of planning, as I said, succeeds in satisfying the functionality in relation to aesthetics by deciding the inclination of the implants and the exit of the screw channel, always a local tongue, so as to not compromise the harmony of the reconstruction.
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Fig. 5
This is the typical technique of immediate loading by conversion of a total prosthesis, inside which a bar welded to TMC1 will be inserted. After a period of 3 to 6 months necessary for osseointegration of the implants, the patient returns to the clinic to scan the prototype that had been worn during the healing period. New photographs are taken with the prototype in place, as well as 3D facial scans. (fig.5) This step is extremely vital and fundamental for the laboratory for the success of the case.
The 3D facial scan reveals the exact inclination of the Maxilla and how much lip support our patient has. Facilitating the positioning of the new arch in the virtual space. In the meantime my laboratory will prepare a confirmation Gig, to make sure that the implants are firmly in the starting position. At this point, when you have all the information necessary to proceed to the next step.
www.dentaltechnician.org.uk 05/10/2021 19:28
