Tissue regeneration and Arcsys Guided Surgery

Author: Dr. Jeferson José Fagundes

67-YEAR-OLD FEMALE PATIENT

Chief Complaint: Fracture of tooth 36, with advanced loss of bone tissue.

Initial evaluation:

Bone and gingival tissue regeneration, virtual planning, implant placement via guided surgery and prosthetic rehabilitation with ceramic crown on Arcsys abutment.

Treatment performed:

The patient was diagnosed with a root fracture in element 36. Tomography revealed an advanced bone lesion resulting from the root fracture, with loss of the buccal and distal walls.

Treatment was divided into stages: extraction of tooth 36 was performed plus curettage of the granulation tissues and synthetic bone graft with Nanosynt bone substitute, granulation 500-1000 µm. A collagen membrane and a PTFE barrier were also used.

After 6 months, a new tomography and intraoral scanning were requested to assess bone regeneration and carry out virtual planning in order to produce a prototyped guide for the surgical installation of the implant.

An Arcsys Implant 4.3 x 13 mm was placed using Arcsys Guided Surgery, which showed excellent primary stability (torque of 60 N.cm). Clinically, bone regeneration was completely successful. A 2 mm Arcsys Abutment was installed, and a personalized healing abutment was made with flow composite on a Multifunctional PEEK Transfer.

After 90 days, the transfer/molding procedures were initiated. The case was completed with the placement of a zirconia crown over a metallic link on the Abutment.

Reconstruction of hard and soft tissues is essential to obtain ideal conditions to place dental implants and prosthetic rehabilitation. The regeneration techniques guided bone grafting and the use of synthetic bone substitutes have shown excellent results in the treatment of maxillary bone defects. Reconstruction of the soft tissues and formation of an appropriate range of peri-implant keratinized tissue are essential to obtain an adequate emergence profile and essential for the health of the gingiva/bone/implant set.

Virtual planning and 3D printing of a prototyped guide have enabled greater precision and agility in the guided surgical installation of dental implants. It is concluded that the association of regenerative techniques of bone and gingival tissues with the technique of installing implants via guided surgery, presents an excellent alternative in rehabilitative dental treatment.

Step by step:

1 - Imagem-do-escaneamento-intra-oral-(pré-operatória)
1 | Intraoral scan image (preoperative).

 

2.1 e 2.2 | Cortes tomográficos do dente 36 e reconstrução 3D
2 | Tomographic sections of tooth 36 and 3D reconstruction.

 

3 | Resultado da regeneração óssea com Nanosynt granulação 500-1000 µm. Resultado após 6 meses.
3 | Result of bone regeneration with Nanosynt granulation 500-1000 µm. Result after 6 months.

 

4 | Planejamento virtual em software para instalação de implantes Arcsys.
4 | Virtual planning in software for Arcsys implant placements.

 

5 | Imagem clínica pré-operatória
5 | Preoperative clinical image.

 

6 | Prova clínica do guia prototipado, vista vestibular.
6 | Clinical trial of the prototyped guide, buccal view.

 

7 | Guia prototipado em posição vista oclusal.
7 | Prototyped guide in occlusal view.

 

8 | Torque alcançado ao final da instalação do implante 60 N.cm.
8 | Torque achieved at the end of implant installation 60 N.cm.

 

9 | Imagem clínica do implante instalado em osso regenerado, via cirurgia guiada.
9 | Clinical image of the implant installed in regenerated bone, via guided surgery.

 

10 | Instalação do Pilar Arcsys com auxílio do parafuso longo para moldagem aberta.
10 | Installation of the Arcsys Abutment with the aid of the long screw for open molding.

 

11 | Pilar Arcsys 2 mm adequadamente instalado e acionado
11 | Arcsys 2 mm abutment properly installed and activated.

 

12 | Transferente Multifuncional instalado sobre Pilar Arcsys
12 | Multifunctional transfer installed on Arcsys Abutment.

 

13 | Instalação do Transferente Multifuncional personalizado com resina tipo flow.
13 | Installation of the customized Multifunctional Transfer with flow-type composite.

 

14 | Tecido conjuntivo autógeno.
14 | Autogenous connective tissue.

 

15 | Enxerto do tecido conjuntivo autógeno e suturas finais.
15 | Autogenous connective tissue graft and final sutures.

 

16 | Resultado cirúrgico após 90 dias.
16 | Surgical result after 90 days.

 

17 | Perfil de emergência peri-implantar
17 | Peri-implant emergence profile.

 

18 | Coroa cerâmica em zircônia instalada, vista oclusal.
18 | Ceramic zirconia crown installed, occlusal view.

 

19 | Coroa cerâmica em zircônia instalada, vista vestibular
19 | Ceramic zirconia crown installed, buccal view.

 

20.1 | Imagem inicial. Lesão óssea avançada. 20.2 | Regeneração óssea com Nanosynt e Implante Arcsys. 20.3 | Imagem final. Reabilitação concluída
20.1 | Initial image. Advanced bone lesion. 20.2 | Bone regeneration with Nanosynt and Arcsys Implant. 20.3 | Final image. Completed rehabilitation.

 

21.1 | Lesão óssea avançada. Fratura dentária. 21.2 | Regeneração óssea com Nanosynt. 21.3 | Reabilitação concluída. Implante Arcsys e coroa cerâmica.
21.1 | Advanced bone injury. Tooth fracture. 21.2 | Bone regeneration with Nanosynt. 21.3 | Completed rehabilitation. Arcsys implant and ceramic crown.
Email
LinkedIn
Telegram
Facebook

Most recent posts

plugins premium WordPress

Selecione seu idioma

Select your language

Shop FGM Implants

Componentes Arcsys, Vezza e Fluxo Digital até 60% OFF, promoções em Brocas, kit cirúrgicos e muito mais.