The „Heidelberg immediate restoration concept“
From digital planning without taking an imprint to immediate restoration
Whole-arch immediate restorations require a long-time temporary implant reinforced with metal. But the production of one of those temporary implants takes time, which is the reason why sturdy temporary implants in top quality can’t be used for surgeries the same day.
When it comes to immediate restoration, the traditional way would be to take an imprint during surgery and later a bite registration. But taking imprints during surgery and the exact determination of occlusion is always challenging. Screwing freshly placed implants in and out is always suboptimal. Because of this, we created a new concept in collaboration with implantologists from our region. Most of these problems can be solved thanks to new, digital processes. We can now offer these processes to dentists outside of our region, too.
In this case study, a preexisting prosthesis was used to fixate the exact occlusion. The prosthesis has then been doubled to create a dental planning stent. It then was used to create a DVT in the original occlusion and for the digital planning. Thanks to this modern, digital procedure, it is now possible to create a printed model that already includes the planned positions for the implants before surgery.
From the digital world back to the normal world: Based on the model, we can create a surgical stent, a precise provisional solution which can be placed right after surgery, and a control splint in occlusion which can also be used for the bite registration procedure. There is no need for taking an imprint during surgery anymore.
On this model we can already determine the exact angulations and the gingival height of the multi unit abutments and we can also perfectly prepare the titanium sleeves for the provisional solution. This makes creating the provisional solution easier, because complex editing after fixation in the mouth is not necessary. There is no more need for a whole team of dental technicians to try to give a rough temporary implant a reasonably good shape.
The provisional solution is already reinforced with metal. The palate prop supports the orientation of the abutments and the fixation of the sleeves. After the fixation of the sleeves, the palate prop is being removed. This provisional solution only stays in the mouth until the real, long-term temporary reinforced with metal is ready. This step is only necessary if you want to provide implants the same day the surgery takes place.
The second important element of our immediate restoration concept is the positioning splint. We’re producing it in original occlusion and we’re splitting it depending on the position of the implant. Those single parts need to be connected in the mouth using cofferdam and Pattern Resin, applied with a brush. This way it is guaranteed that the plastic is being sucked in the capillary gap and can’t get into the surgery area. The picture shows this procedure only exemplarily. This way, the positions of the implants are being fixated more exactly than any imprint ever could.
This positioning splint then gets put back on the same model on which we already prepared the gingival management, together with the new model implants.
We now have the exact positions for the implants and the perfect bite registration procedure. We can now produce the long-term temporary, reinforced with metal, in one go.
With this new procedure, we are now able to produce a dental surgery stent, a temporary implant and a positioning splint, which also functions as a bite base, after only one 3D implant planning and in time for the surgery. So now you can offer immediate restoration without the need of an imprint for your surgeries. We can provide you with the needed technology.