Real clinical case : rehabilitation of a upper jaw with Winmed 2 Pro and Galileo 1 device(Patent Pending). In this description we will explain briefly a real clinic case executed with prosthetic guided surgery, with flapless method. And then the immediate application of a fixed temporary bridge. We have used the software Winmed Pro 2 together with Galileo 1 device. This treatment is equally valid when using Copernico as device for transferring the data. Both devices are produced by: Artiglio-Italia S.N.C. The implants are instead produced by: Oralplant S.R.L You can see the panoramic radiography of the initial situation.This intervention does concern the maxillar arch. We have prepared for the patient a radiographic mask with radiopaques teeth in ideal position and included a plane (called Spot Stage) containing radiopaque spheres positioned onto the mask (see the method described for the experimental case ) this allow to highlight a precise referring system in the space. The patient makes the TC wearing such mask and the dataset resulting will be imported in the software Winmed Pro. This allows the following proceeding for calibration/reformat of the TC and the virtual positioning of the implant in the position considered the more suitable to the bony availability ( with reference to the radiopaques teeth of the ideal prosthetic mounting, which are highlighted on the TC same). In this specific case we will have to position 7 implants. These are the screens relevant to the first two implants which have been positioned in such way to have the correct space orientation with respect of the anatomical structure of the patient and of the ideal prosthetic mounting. When referring to the Galileo 1 and Copernico devices for each implant the software creates 4 values ( 2 angular values and 2 values for linear compensation which are sufficient and necessary to set up the inclination of the RAP-ARTIGLIO BASE ( in the case you use the Galileo1 device) or to program Copernico device in the case you use this item. The linear values are reported on the base of the transparent plane of Galileo 1 device, while the angular values reported on the RAP-ARTIGLIO BASE, helps to re-find the direction of the implant planned with Winmed software. With the help of a vertical drilling machine, it will be possible to make the holes on the original radiological mask which will became (after fixing of the guides) the surgical guide to assist the drill during the preparation of the implant sites. The surgical guides are fixed using a small quantity of photo or auto-polymerising resin . The surgical template is ready and (after disinfection and sterilization phases) it will be ready for the surgical intervention. Seen that the pre-surgical planning gave favourable indications, we will proceed to the intervention (with flapless approach) by drilling directly (drilling 2 mm width and 7-8 mm deep in the bone) in such way to mark already the seat of implant input on the cortical and its direction for the first mm in the bony structure. We check then the execution of the first guide hole and with a circular scalpel it will be comfortably possible to create a precise access by removing just the gum portion necessary for completing the implant site and the next screwing of the implant itself. By following the guide given by the first hole we will proceed with the completing of the implant site. In this case the depth of the site is controlled by a suitable vertical stop. We proceed then by inserting the implant (in this case with a manual wrench) and following the same proceeding we will prepare the following implant sites. Execution of the holes on the right side of the maxilla, after the picture with intervention gone to end with all the implants inserted. We have then done the extraction of the third molar, just for this you can notice the unique suture necessary during the intervention. Now we have to screw the abutments and fit the temporary bridge which will then be fixed for the healing period; after this the patient can be dismissed. In a next clinic case we will explain the simplified version of this tecnique employing also temporary abutments made of acethalic resin which facilitate the management of the temporary bridge. The present case will be completed in its iconography and description as son as we will proceed with the rehabilitation with the final fixed prosthesis. For further information please do not hesitate to write us . Click on the following images to enlarge the catalogue's pictures.
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