Cas cliniques
Dr Philippe
HERAUD
Aix-en-Provence - France
Mr Frédéric
FOURET
Design Dentaire dental lab
Partial dental rehabilitation with Axiom® TL (Tissue Level) implants
A 48-year-old female patient, a smoker, in good health. History of orthodontic treatment with avulsion of 14, 24 and 34.
1-2- 36 present with an apical hotbed of infection. As an endodontic treatment attempt is a good prognosis, this option is preferred. 46 and 45 are missing. 25, missing, is replaced by a cantilever bridge 25-26-27. 16, 26 et 37 present with an apical hotbed of infection. The endodontic treatment of these teeth is not a good prognosis. 47: presents with terminal iatrogenic periodontitis and an apical hotbed of infection. These 4 teeth will be extracted. In total, 7 teeth will be replaced.
1-2- 36 present with an apical hotbed of infection. As an endodontic treatment attempt is a good prognosis, this option is preferred. 46 and 45 are missing. 25, missing, is replaced by a cantilever bridge 25-26-27. 16, 26 et 37 present with an apical hotbed of infection. The endodontic treatment of these teeth is not a good prognosis. 47: presents with terminal iatrogenic periodontitis and an apical hotbed of infection. These 4 teeth will
be extracted. In total, 7 teeth will be replaced.
3- 10 weeks after extraction, the sites are properly healed.
4-5-6- The implant placement can then be performed in optimal conditions, with immediate restricted activation in the 4th quadrant with screwretained
solidified temporary prosthesis Axiom® TL (Tissue Level) implants in 45 – 46 – 47). The reduced primary stability of implant 26 that has required simultaneous sinus lift bone increase will not permit this option for 25 and 26.
4-5-6- The implant placement can then be performed in optimal conditions, with immediate restricted activation in the 4th quadrant with screwretained
solidified temporary prosthesis (Axiom® TL (Tissue Level) implants in 45 – 46 – 47). The reduced primary stability of implant 26 that has required simultaneous sinus lift bone increase will not permit
this option for 25 and 26.
6- Post-operative follow-up X-ray.
7-8-9- Construction of 3 temporary elements solidified on temporary titanium abutments.
8- Occlusal view of the temporary prosthesis.
9- A guiding lock of the inLink® integrated system was placed in the centre to aid placement of the prosthesis.
10- Clinical appearance 14 days after surgery: occlusal view.
11- Clinical aspect 14 days after surgery: note the appearance of the peri-implant gum.
12- CAD model of the Simeda® frame.
13-14- Final Zircone-Ceramic prosthesis In place in the 4th posterior quadrant 10 weeks after surgery.
14- Final prosthesis, vestibular view.
15- Endo-local follow-up X-ray 10 weeks after surgery
16- Follow-up panoramic X-ray (OPG) 4 months after surgery.
Conclusion
For the prosthetic treatment of this patient, initially planned with Axiom® BL (Bone Level) implants, we had the option of using Axiom® TL (Tissue Level) implants in the 4th quadrant. We can only be too happy we did. The result was considered very satisfactory by the patient and the team, and the clinical and prosthetic procedures
were simplified. The ideal emergence profile of this new implant, the flexibility offered by the “customised” placement of the emergence of the prosthetic screw channels and the extreme safety of the biological area are the strengths of this new system, which from now on defines a new standard in multiple restorations of posterior sectors.
