Dr. Meir Mamraev, DMD,. LLB,. - The Future of Dental Implants Reports/Guided Surgery - Case...

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Dr. Meir Mamraev, DMD,. LLB,.Graduated from Dental school of Iasi University in 1992 and Law

school of Ono College in 2005.One of the founders of Cortex company. Senior Vice

President of research and Developmentat Cortex dental implants industries LTD.

Head of postgraduate training programs and academical activities of Cortex.

Worldwide lecturer as well as an owner of a private dental practice in Tel-Aviv, Israel.

info@cortex-dental.infowww.cortex-dental.com

CASE 1............................................3-7

CASE 2............................................8-11

CASE 3............................................12-18

CASE 4............................................19-22

CASE 5............................................23-27

INDEX

3

CASE 1 (Dr. Meir Mamraev – Israel)

Diagnostics

Age: 59

Gender: Female

Periimplantitis: 27

Roots #13, #15, #11, #21, #22, #23, #24 deep caries and fractured crowns with no option for rehabilitation. General Health: good

Digital files: CBCT scan & Digital impression

4

CBCT SCAN

MODEL STL

PANORAMIC X-RAY

CASE 1

5

Treatment Plan

1. Prosthetically driven virtual implant planning- 3Shape Implant Studio: Safety Zone – apical distance – 2.0 mm

Safety Zone – radical distance – 1.5 mm

Position #15: Ø3.8 / 11.5mm – Dynamix Conical

Position #12: Ø3.8 / 11.5mm – Dynamix Conical

Position #22: Ø3.8 / 11.5mm – Dynamix Conical

Position #23: Ø3.8 / 11.5mm – Dynamix Conical

Position #27: Ø3.8 / 11.5mm – Dynamix Conical

CASE 1

6

2. Guided Surgery - Cortex Guided Surgery Kit + Cortex Guiding sleeves

Teeth extraction #13, #14, #11, #21, #22, #23, #24, implant #27 removal Implant placement: #12, #15, #22, #23, #27 Immediate full arch temporization, including existing implants #16, #17, #25, #26

3. Surgical guide

4. Immediate temporization with PMMA total bridge on Multi-units. Implant #27 was not loaded. Operation

Operation Date: 23/10/2018 Flapless procedure Execution of the treatment plan

CASE 1

7

Clinical Follow-Up including X-ray and dates

Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.

14 12

22

27 25

CASE 1

8

CASE 2 (Dr. Meir Mamraev – Israel)

Diagnostics

Age: 77

Gender: Female

Teeth #44, #45, #46, #47 are missing

General Health: good

Digital files: CBCT scan & Digital impression

9

Treatment Plan

1. Prosthetically driven virtual implant planning - 3Shape Implant Studio Safety Zone – apical distance – 2.0 mm

Safety Zone – radical distance – 1.5 mm

Position #44: Ø3.8 / 13mm – Dynamix Conical Position #46: Ø3.8 / 10mm – Dynamix Conical

CBCT SCAN

MODEL STL

CASE 2

10

Position #47: Ø4.2 / 8mm – Dynamix Conical

2. Guided Surgery- Cortex Guided Surgery Kit + Cortex Guiding sleeves 3. Implant placement position #44, #46, #47 4. Surgical guide

Operation

Operation Date: 21/10/2018

Flapless procedure Guided surgery for implant placement 44, 46, 47

CASE 2

11

Clinical Follow-Up including X-ray and dates

Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.

Implant 44

Implant 47

Implant 46

CASE 2

12

CASE 3 (Dr. Meir Mamraev – Israel)

Diagnostics

Age: 64

Gender: Male

Fully edentulous lower case

Old removable denture

General Health: good

Digital files: Dual scanning protocol:

CBCT of denture with 3D markers

CBCT of the same denture inside patients’ mouth

13

CASE 3 Treatment Plan

1. Prosthetically driven virtual implant planning- 3Shape Implant Studio Safety Zone – apical distance – 2.0 mm

Safety Zone – radical distance – 1.5 mm

Position #32: Ø3.8 / 11.5mm – Dynamix Conical Position #33: Ø3.8 / 16mm – Dynamix Conical

CBCT of the denture inside patients’ mouth CBCT of denture with 3D markers

CASE 3

14

Position #42: Ø3.8 / 11.5mm – Dynamix Conical Position #43: Ø3.8 / 16mm – Dynamix Conical

2. Guided Surgery- Cortex Guided Surgery Kit + Cortex Guiding sleeve Implant placement in positions: #32, #33, #42, #43 + 3 fixation pins for guide stabilization. Immediate temporization- total PMMA bridge fixed on Angulated multi units.

CASE 3

15

3. Surgical guide

PMMA bridge, Digital model Analog & Surgical Guide Operation

Operation Date: 23/10/2018

Raised flap procedure Cortex Guided Surgery kit Guided implant placement in position: #32, #33, #42, #43 Manual bone straitening & reduction Guided bone milling as a preparation for angulated multi-unit placement Immediate temporization with PMMA bridge All components, including the temporary bridge, were prepared in advance. The prosthetic solution was delivered on a Digital model

4. CAD CAM prosthetic solution - Virtual Design

CASE 3

16

Clinical documentation:

Checking guide fit & stability Fixation pins

Site preparation Implant placement Bone reduction Guided bone mill

CASE 3

17

Multi-unit placement Titanium sleeves placement Passive fit of the prosthesis Final result

CASE 3

18

Clinical Follow-Up including X-ray and dates

Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.

Implant 44 Implant 42

Implant 32 Implant 34

CASE 3

19

CASE 4 (Dr. Meir Mamraev – Israel)

Diagnostics

Age: 56

Gender: Female

Teeth #46, #47 are missing

General Health: good

Digital files: CBCT scan & Digital impression

20

CASE 4 Treatment Plan

1. Prosthetically driven virtual implant planning- 3Shape Implant Studio Safety Zone – apical distance – 2.0 mm

Safety Zone – radical distance – 1.5 mm

Position #46: Ø3.8 / 10mm – Dynamix Conical Position #47: Ø3.8 / 8mm – Dynamix Conical

CBCT SCAN MODEL STL

CASE 4

21

CASE 4 2. Guided Surgery- Cortex Guided Surgery Kit + Cortex Guiding sleeve

Implant placement in positions: #46, #47.

3. Surgical guide

Operation

Operation Date: 20/09/2018 Raised flap procedure/ flapless procedure

Guided surgery for implant placement 46

CASE 4

22

CASE 4

Clinical Follow-Up including X-ray and dates

Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.

Implant 46 Implant 47

CASE 4

23

CASE 5 (Dr. Meir Mamraev – Israel)

Diagnostics

Age: 70

Gender: Female

Fully edentulous upper case

Removable denture

General Health: good

Digital files: dual scan technique

24

CASE 5 Treatment Plan

1. Prosthetically driven virtual implant planning- 3Shape Implant Studio Safety Zone – apical distance – 2.0 mm

Safety Zone – radical distance – 1.5 mm

Position #12: Ø3.8 / 13mm – Dynamix Conical Position #13: Ø3.8 / 13mm – Dynamix Conical

CBCT of the denture with 3D markers inside

the patients mouth CBCT of the denture with 3D markers

CASE 5

25

Position #22: Ø3.8 / 13mm – Dynamix Conical Position #16: Ø3.8 / 16mm – Dynamix Conical Position #23: Ø3.8 / 13mm – Dynamix Conical Position #26: Ø3.8 / 16mm – Dynamix Conical

CASE 5

26

2. Guided Surgery- Cortex Guided Surgery Kit + Cortex Guiding sleeve

3. Surgical guide with three fixation pins

Operation

Operation Date: 19/12/2018 Flapless procedure

Guided surgery for implant placement in position #16, #13, #12, #22, #23, #26

CASE 5

27

Clinical Follow-Up including X-ray and dates

Conclusion There were no signs of peri-implantitis around the implants on none of the follow up OP after implant placement, no fibrosis, and no bone loss value. The bone integration around the implant progressed according to plan without fatty infiltration, granuloma, etc.

CASE 5

info@cortex-dental.info www.cortex-dental.com