Case report Dr. Dov Kischinovsky

Prosthetics:Dr.Biler,Jerusalem

Case report

Female patient,68 years old

Severe bone loss after failed implants

Complaint:Unstable dentures,Esthetics,Self-

esteem

2006:

68 Year Old Female, Lost All Implants At 60 - Severe Bony

Atrophy

Initial Examination- 2006

DrDov

Kischinovsky

Anterior Maxillary Bone-graft Combined With Long Posterior Fixtures Positioned In Zygomatic Bone And Pterygoid Region.

Lingually Placed Lower Implants Circumventing Mandibular Canal

Initial Examination

Maxillary Complete Edentulism

Extreme bone loss

Class 3-max-mand relationship

Mandibular Posterior Edentulism

Advanced Periodontitis

Significant Verticular Bone loss

DrDov

Kischinovsky

Maxillary retroposition

DrDov

Kischinovsky

Radiopaque ScannoGuide

DrDov

Kischinovsky

From scan

DrDov

Kischinovsky

From scan

DrDov

Kischinovsky

Initial Examination

Conclusion: Resorbed small jaws

Little Bone volume

Low Bone density

Unsatisfactory Jaw Relations

Unsatisfactory intermaxillary

Distance

DrDov

Kischinovsky

SimPlant SimPlant

From Scan

Tooth

DrDov

Kischinovsky

3D-scan

3D-Scan

From scan

Mandibular Posterior Edentulism

Advanced periodontitis

Significant Verticular bone loss

DrDov

Kischinovsky

Treatment Plan: Stage I

Treatment plan: Prepare Accurate Maxillary and Mandibular

ScannoGuide

Surgery stages:

1: Loweer posterior implants with BS SurgiGuide

2:4 Upper Jaw:4 Transinoidal Implants(2 zyg+ 2 pterygoid)

Autogenous Block augmentation of Premaxilla.

3:Navigator Set for Ant.Upper Implants

and Lower Implants

s

Upper jaw: 2 zygoma and 2 pterygoid implants

Premaxillary Bone Augmentation

Lower Jaw :6 posterior implants

DrDov

Kischinovsky

Treatment Plan: Stage II

Treatment plan: Prepare Accurate Maxillary and Mandibular

ScannoGuide

Surgery stages:

1: Loweer posterior implants with BS SurgiGuide

2:4 Upper Jaw:4 Transinoidal Implants(2 zyg+ 2 pterygoid)

Autogenous Block augmentation of Premaxilla.

3:Navigator Set for Ant.Upper Implants

and Lower Implants

s

Upper jaw: 6 anterior implants

Lower Jaw Extractions and anterior implants

DrDov

Kischinovsky

To plan Cross-section of implant

Tooth 46 Tooth 45

DrDov

Kischinovsky

3 implants left side

SimPlant SimPlant

From scan

DrDov

Kischinovsky

To plan: Mandible posterior

Conversion of the CT data to 3D file:

Surgery planning with SimPlant®

SurgiGuide® type

SurgiGuide® solution

Immediate loading

Temporary prosthesis

Final prosthesis

Bone Supported

UniversalGuide Lower Jaw One Piece Implants

Acrylic Prosthesis

PFM

DrDov

Kischinovsky

Lower Jaw Posterior implants

To plan

Surgery:Lower Posterior Jaw

Surgery:Lower Posterior Jaw

Surgery:Lower Posterior Jaw

Surgery Lower Jaw

Surgery Lower Jaw

Post-Op Lower Jaw

Anterior Lower Jaw-Stage II

DrDov

Kischinovsky

Anterior Lower Jaw-Stage II

DrDov

Kischinovsky

To guide Post-operative x-ray

DrDov

Kischinovsky

Anterior Lower Jaw-Stage II

DrDov

Kischinovsky

DrDov

Kischinovsky

DrDov

Kischinovsky

Try in of Metallic Framework

DrDov

Kischinovsky

Final Lower Bridge

DrDov

Kischinovsky

Final Lower Bridge

Final Lower Bridge

DrDov

Kischinovsky

Uppper Jaw-Stage I

68 Year Old Female, Lost All Implants At 60 - Severe Bony Atrophy

DrDov

Kischinovsky

To plan:Maxilla

Scan Prosthesis Showing Bone Restoration

To plan:Maxilla

Conversion of the CT data to 3D file:

Surgery planning with SimPlant®

SurgiGuide® type

SurgiGuide® solution

Immediate loading

Temporary prosthesis

Final prosthesis

Bone Supported

Zygoma-Guide

Augmentation Premaxilla

No

Acrylic Prosthesis

Ceramic Bridge Work

DrDov

Kischinovsky

Scan-prosthesis In Ct-cross Cut

Surgical Drill Guide For Trans-sinusal Implants With Steel Cylinders

DrDov

Kischinovsky

DrDov

Kischinovsky

SurgiGuide For Preparing Pterygoid And Zygomatic Implants In Upper Jaw

DrDov

Kischinovsky

DrDov

Kischinovsky

Simulation Of Bone-grafting On Knife-edge Premaxilla On Stereolithographic Model Before Intra-oral Fixation

Anterior Maxillary Bone-graft Combined With Long Posterior Fixtures Positioned In Zygomatic Bone And

Pterygoid Region.

Lingually Placed Lower Implants Circumventing Mandibular Canal

3D Models before and after bone augmentation

DrDov

Kischinovsky

To Surgiguide x-supported Navigator SurgiGuide®.

To guide Post-operative x-ray

DrDov

Kischinovsky

Pre-operative

Pre Treatment Ant.Autogenous Bone Graft Positioning Implants

DrDov Kischinovsky

SurgiGuide (Navigator ( System

Second Stage: Premaxillary Implant Placement

Upper Jaw-Navigator Kit

DrDov

Kischinovsky

DrDov

Kischinovsky

To guide Clinical photograph of surgery – Post 0p

To guide Clinical photograph of surgery

DrDov

Kischinovsky

DrDov

Kischinovsky

DrDov

Kischinovsky