Implantation Using Mouth Model

Prosthodontists often face difficulties trying to define position of tooth implants. In this article a case is described when a patient had no upper first molar and premolar.

In prosthetic dentistry a method of computer modeling or a method of making diagnostic model in the form of a mock up of a patient’s teeth are used. In this case, when the man addressed the doctor in order to place upper lateral teeth, the second method was applied.

It was chosen, because it gives a chance to a prosthodontist and surgeon to work together. A surgeon will be responsible for preparation of environment for implantation. An orthodontist will take care of making the prosthesis and placing it into the mouth. The result of such cooperation will be reliable and safe implantation for a patient.

First radiography and cone-beam computer tomography (CBCT) showed how the patient’s bite looked before placing prostheses, and where the implants should be placed. Then a mock up of the mouth was made according to which the patterns of new teeth were created.

The doctors got answers to some questions due to the model. Like what size the implant should have? In this case the specialists found that a 7 mm abutment for denture treatment is needed. Placing a construction of this size is a nice decision for the patient’s mesio-distal space.

With the help of Ministar equipment a radiographic template of the future prosthesis was created. At the spot of its placement in the diagnostic model a hole was made. Then the template was adjusted to the model by means of a simple rope. It helped the surgeon estimate the scope of further work and make treatment plan after defining in what state hard and soft tissues were. This step also helped predict future position of the implants in the mouth.

If needed, the diagnostic model can be used by a surgeon in the course of implant placement. In this case it really happened: the apertures were expanded for test denture treatment on the model.

According to the model, prosthesis material was created and placed in the patient’s mouth. After that the doctors conducted another CBCT. The dentists (the surgeon and orthodontist) made a plan of further hard and soft tissue treatment.

Steve Ratcliff, D.D.S., M.S., Spear Faculty and Contributing Author