Journal of Oral Implantology October 2014 - (Page 623)

CASE LETTER A Surgical Guide for Optimal Placement and Immediate Restoration of Implant Santosh Nelogi, MDS1* Bhasma Srinivas Rao, MDS2 Naveen H. C., MDS3 Amit Porwal, MDS4 Maheshwari Nelogi1 INTRODUCTION T he success of an implant is primarily dependent on the diagnosis of the preexisting conditions of the patient and also on the treatment planning. The essential aspect of treatment planning is proper assessment of an implant site through examination, palpation, and radiographic methods. Different radiographic methods have been used to evaluate the bone quantity and architecture at the proposed implant site, ranging from conventional to 3-dimensional models.1 The assessment of implant sites and their further evaluation can be enhanced by using radiograph templates with radio-opaque markers for placement of implants at proposed implant sites.2-6 Precise and appropriate placement of a dental implant with proper angulation to achieve desired esthetic and functional results has always been a challenge to an implantologist. Implantology is a multidisciplinary field; therefore, a team approach between a maxilla-facial surgeon and a prosthodontist is essential in the precise and effective rehabilitation of the patient. Any communication gap between the surgeon and prosthodontist leads to confusion at the time of implant placement regarding the position or angulation of an implant. This confusion can make an implant unrestorable, especially in the anterior maxillary region.7 1 Department of Prosthetic Dentistry, Kle Vk Institute of Dental Science, Belgaum, Karnataka, India. 2 Department of Prosthetic Dentistry, Mamata Dental College, Khammam, Andra Pradash, India. 3 Department of Prosthodontics, Surendra Dental College and Hospital, Sri Ganganagar, Rajasthan, India. 4 Department of Prosthetic Dentistry, Pacific Dental College and Hospital, Udaipur, Rajasthan, India. * Corresponding author, e-mail: santrodent@rediffmail.com DOI: 10.1563/AAID-JOI-D-12-00005 Position, angulation, implant diameter, and length of an implant need to be decided before the surgery is planned. A thorough review of the literature reveals several techniques of fabrication of surgical guide stents for the placement of an implant.3-17 The surgical guide stent described in the literature cannot (1) guide the drill to the full depth, (2) give a picture of implant inclination within bone, (3) indicate the shape of the implant required in accordance with bone architecture at the proposed implant site, or (4) help achieve postrestoration esthetics in immediate restoration cases. These surgical guides only aid in positioning of the implant. Hence, there is a need for an analog technique to fabricate a surgical guide that allows placement and restoration of an implant in a precise, predetermined position and allows esthetic restoration immediately after surgery. This article describes a technique of fabrication of a surgical guide stent that enables the surgeon to maintain the predetermined angulation of an implant at the proposed site and at the same time provides information about the implant diameter and angulation of the abutment required for esthetic restoration. PROCEDURE 1. An irreversible hydrocolloid impression is made, from which a cast is poured into dental stone. 2. Using a pin index system, the removable die of the proposed implant site is prepared. 3. Bone mapping is done under local anesthesia, and the distance of insertion into soft tissue is measured on the labial and lingual aspects of the alveolar ridge at varying vestibule depths. Journal of Oral Implantology 623

Table of Contents for the Digital Edition of Journal of Oral Implantology October 2014

New AAIP Affiliates Increase JOI Readership
Letter to the Editor
Bone Response From a Dynamic Stimulus on a One-Piece and Multi-Piece Implant Abutment and Crown by Finite Element Analysis
Effect of Platelet-Rich Plasma on the Healing of Mandibular Defects Treated With Fresh Frozen Bone Allograft: A Radiographic Study in Dogs
Efficacy of Growth Factor in Promoting Early Osseointegration
Assessment of Candida Species Colonization and Denture-Related Stomatitis in Bar- and Locator-Retained Overdentures
A Simple Solution for Vector Control in Vertical Alveolar Distraction Osteogenesis
Maxillary Ridge Augmentation With Custom-Made CAD/CAM Scaffolds. A 1-Year Prospective Study on 10 Patients
A Retrospective 3- to 5-Year Study of the Reconstruction of Oral Function Using Implant- Supported Prostheses in Patients With Hypohidrotic Ectodermal Dysplasia
Effects of a New Implant Abutment Design on Peri-Implant Soft Tissues
Repair Technique for Fractured Implant-Supported Metal-Ceramic Restorations: A Clinical Report
Full-Mouth Rehabilitation for a Patient With Dentinogenesis Imperfecta: A Clinical Report
New Method to Increase Inter-alveolar Height With Preservation of Crestal Cortical Bone for Implant Treatment
Implant Placement With a Guided Surgery System Based on Stress Analyses Utilizing the Bone Density: A Clinical Case Report
A Novel Technique for Osteotome Internal Sinus Lifts With Simultaneous Placement of Tapered Implants to Improve Primary Stability
Maxillary Sinus Augmentation and Implant Placement Using Venous Blood Without Graft Material: A Case Letter
Modification of Maxillary Sinus Floor With Orthodontic Treatment and Implant Therapy: A Case Letter
A Surgical Guide for Optimal Placement and Immediate Restoration of Implant
Osseointegrated Dental Implants in Growing Children: A Literature Review

Journal of Oral Implantology October 2014