Radiographic stent aids in implant installation and sinus augmentation

Multiple implant installation using radiographic stent and sinus augmentation using CAS kit

By: Dong-Seob Lee


Introduction:

In the case of partial edentulous area is extensive, implant placement in the exact position with right direction is very difficult. Especially, as the number of implants increases, placement in the correct position is an important factor in determining the prognosis of the final prosthesis. So, it is necessary to have a surgical stent especially for less experienced clinicians. Of course, the recent trend is to use computer-guided implant surgery. For the procedure, the CT data and the model scan data must be accurately superimposed so that a final surgical stent can be produced with a good fit in the patient’s mouth. Therefore, in many cases, CT is taken with a radiographic stent for this purpose.


Purpose:

In this case, computer guided surgery was planned initially, but the patient had to complete the implantation within a short period of time. So, a radiographic stent was modified and used as a surgical stent instead of computer-guided implant surgery to reduce the treatment time. Compared to the stent made with computer – guided surgery, since it is not accurate enough to use until final drilling, it can be used as an marker for initial position.


Case Presentation:

Age/Sex : 60 / F

Chief complain : loss of tooth.

Treatment plan : Implants were planned to installed in the mandible at #32,43,44,46 area, and a 3-unit bridge of # 46-X-44 type implant prosthesis and a 5-unit bridge of #43-X-X-X-32 type prosthesis were planned. For the #16 area, implant installation with sinus augmentation using CAS kit (Osstem, Seoul, Korea) was planned due to limited alveolar bone height.

Panoramic radiograph
Fig. 1. treatment plan

Radiographic stent was fabricated and fitted on the day of CT taking. After taking CT, radiopaqe material was removed and the hole was trimmed to change the form to surgical stent.

The stent was used as an marker for initial position and implants were installed successfully in the right position. #16 implant was also installed with crestal approach sinus augmentation. All of them had good primary stability with insertion torque more than 30N.

Post op panoramic radiograph
Fig. 2. Post-Op

Conclusion:

In the case of partial edentulous area is extensive, implant placement in the exact position with right direction often requires surgical stent for beginner level clinicians. Both surgical stent made by computer guide system and by conventional laboratory method can provide us useful guide for surgery.

 

 

 

 

 

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