Post ortho treatment with limited mesio-distal space.
Slide 1
This case was referred in our clinic, post-orthodontic treatment for replacement of the congenitally missing lateral incisors with dental implants.
Slide 2
The first step of evaluation is to determine the available mesio-distal space. The use of Cervico Guide (cylindrical tabs) reveals available space of 6mm. This means that we can safely place an implant with 3mm prosthetic platform size without jeopardizing the principles of “safety zone”.
Slide 3
The same cylindrical tab (6mm) of the Cervico Guide is placed in the edentulous space and used as a surgical guide to ensure initiation of implant osteotomy at the center of the prosthetic space. For this step, we utilize the pilot drill available with the implant surgical tray.
Slide 4
Upon completion of initial osteotomy, the blue Cervico Guide (LINK) pin is introduced into the osteotomy for evaluation of the position and angulation of the latter. An extra information we get at this stage is the evaluation of the available open space between the ring of the pin and the adjacent roots. The ring of the blue pin has a diameter of 3mm and thus resembles the prosthetic platform of the implant to be placed.
Slide 5
The Cervico Guide anatomical tab suitable for the prosthetic space of lateral incisor (aS - anterior Small size) is installed onto the Cervico Guide pin. The frontal observation reveals adequate space between the lateral walls of the tab and the adjacent roots. This means that a Cervico healer aS will be able to be installed onto the implant with no needs for any modifications of its lateral walls.
Slide 6
The occlusal observation reveals that the aS Cervico healer will be ideal for the soft tissue conditioning of this site. The anterior border of the tab and thus the healer must substantially match the Cervical border of the future crown without extending further buccally than this border. At this stage, the tab can be installed onto the pin either at the center or off-center position. This determines the use of a center or off-center Cervico aS healer. In this case, an off-center Cervico aS healer will be utilized.
Slide 7
The implant is placed and with the use of Cervico caliper (link) we evaluate proper depth of placement which ideally is 4mm apical to the zenith point of the future prosthesis. The CEJ of the adjacent teeth is used as a reference for this measurement
