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Open access

Zoran Vlahović and Mirko Mikić

Summary

Background: Cone Beam Computer Tomography (CBCT) is representing a new concept of radiological diagnostics and its application occupies a special place in implantology. Today, preoperative planning, and quantitative and qualitative jaw bone analysis cannot be done without the use of these techniques. The latest in a series of achievements in this field is a method of making a guide for implant using a 3D printing technique. This way pre implantology planning reduces the chance of surgical complications to a minimum and allows installation of dental implants in the most optimal position for future prosthetic work. Aim: To show benefits of guide implantation in clinical practice.

Case report: The patient M.D. 36 years old. After making CBCT there was a qualitative and quantitative analysis of bone tissue, after which we decided to install five implants in positions #36, #37, #45, #46 and #47. The software appliance made virtually implants in the most optimal positions; treatment plan was forwarded by the internet connection into the DICOM format to Simplant Company, along with a folder of scanned plaster models in order to develop a guide. A few days later, after approval sent, we received the guide. Preparation by the pilot bur we did through transmucosal plum of the guide, and then we continued the classic flap surgery technique. Control footage shows the optimal position of the implant from both surgical and prosthetic aspects.

Conclusion: Application guide implantology represents a safe and modern method that provides ability of implant placement in optimal positions in terms of future prosthetic rehabilitation.

Open access

Aleksandar Đorđević, Mirko Mikić, Jelena Stanišić and Filip Đorđević

Summary

Background/Aim: Implant treatment expands extensively the possibilities of prosthetic treatment, which provide benefits, bigger comfort as well as general improvement of the patient’s life quality. In cases with no possibility of implantation, it is possible to improve conditions by using modern methods for bone tissue repair. One of factors important for the long-term success is proper oral hygiene, as well as raising awareness of its importance to patients. The aim of the paper is to present a patient rehabilitated with multiple implants and followed-up for a five-year period, and to point out the importance of raising patient’s awareness and motivation in order to preserve the results of the treatment.

Case Report: A 31-year-old patient was admitted to the oral surgery clinic for rehabilitation of a poor oral health status. After taking history, clinical examination and additional analysis, the following treatment plan was suggested: to remove impacted upper canines and to put an implant supported by fixed prosthesis in the upper jaw, to make two implants supported by bridges laterally and one dental supported by bridge in the inter-canine sector in the lower jaw. The treatment was carried out in several stages that involved extraction of residual roots and impacted teeth, augmentation of bone defects with bone substitutes and bio-absorbable membranes, placing implant, and prosthetic rehabilitation. By verbal communication with the patient, we pointed out the importance of proper oral hygiene and regular check-ups. The five year follow-up showed the absence of factors that could adversely affect the success of the treatment, and the patient was still highly motivated to maintain proper oral hygiene.

Conclusions: It is possible to achieve predictable results in complex cases by using a multiphase prosthetic treatment supported by implants. Concerning a long-term success, motivation, proper information and patient’s willingness to cooperate play an important role.