Guided-welded approach planning using a computer-aided designed prosthetic shell for immediately loaded complete-arch rehabilitations supported by conometric abutments.
In guided surgery, implants can be planned from radiographic guide information according to a restoratively driven treatment plan. Unfortunately, the palatal or lingual surface of teeth cannot be easily identified. The present article describes the use of a digitally designed prosthetic shell to improve the accuracy of guided-welded approach planning for immediate restorations supported by conometric abutments. Importing the virtual shell into the planning software provides an effective protocol for using the definitive prosthetic space information to plan the framework shape and position predictably. This method increases the accuracy of virtual planning and reduces the time needed to reline the prosthetic shell.
The Conometric Connection for the Implant-Supported Fixed Prosthesis: A Narrative Review
Aim: The conometric concept was proposed as a possible connection between the abutment and the prosthetic coping. This research aimed to review the features and possible clinical uses of this connection in an implant-supported fixed prosthesis. Methods: An electronic search was conducted on an online database for the topic in object; articles published in international literature were considered and the research gave 17 results, and 6 parameters were analyzed. Results: This connection eliminated the possibility of cement residues in the subgingival region, reducing the risk of inflammation of peri-implant soft and hard tissues; not having to remove the cement residues, it is possible to place the margins in more apical portions, improving the aesthetics outcomes of the rehabilitations. It is also known that the retention by means of a screw causes a weakening of the restoration. The retentive force is adequate for fixed rehabilitation even after a high number of insertion–disengagement cycles; in vitro studies have also shown a high bacterial sealing. Implant rehabilitation using preformed components, such as conometric hoods, is helpful for CAD/CAM, so a digital workflow is possible. Several types of prosthesis were presented, all of which demonstrated adequate clinical performance in the follow-up observation. Conclusions: This type of connection seems to be suitable to support fixed implant rehabilitations, but long-term clinical studies are needed to validate this system.
The use of CT scan based planning for oral rehabilitation by means of implants and its transfer to the surgical field: a critical review on accuracy.
The purpose of the present paper is to review the literature on the use of CT scan based planning for oral rehabilitation and its transfer to the surgical field by means of a surgical guide. The first part will deal with surgical guides based on tomographies or CT scan data often using dedicated software, but manually fabricated. In the second part, CT-derived drill guides are discussed, which are fabricated by means of CAD/CAM technology or other computer-controlled technology. The deviations between the position of the implants at the planning stage and after the surgery are of utmost importance, especially when flapless procedures are applied. The maximal deviations are often not stated in the literature. This should be taken into account when a system is applied clinically.