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Clinical cases


Dr Francis

BAILLY

Doctor of Dental Surgery, School of Medicine Lyon University


Mr. Alexandre

BIENFAIT

Bienfait dental lab

Advantages of the Axiom® Multi Level® solution

A 49-year-old patient presenting with high mobility and pain. The panoramic X-ray shows us a terminal stage of periodontal disease with tooth migration. Initially, only the upper maxilla will be treated opting for an all-on-4, which requires a single procedure only and will be performed in 5 months’ time.

1 – Initial smile.

2 – Pre-operative panoramic X-ray.

3 – Initial clinical situation.

4 – Use of Prof Itzhak BINDERMAN’s Smart Dentin Grinder to obtain a powder of decontaminated particulate dentin mixed with APRF. 4 teeth are used to compensate the bone losses.

4 – Use of Prof Itzhak BINDERMAN’s Smart Dentin Grinder to obtain a powder of decontaminated particulate dentin mixed with APRF. 4 teeth are used to compensate the bone losses.

5 – Mixture obtained from just 4 teeth.

6 – Temporary 25° angulated abutments to follow the inclination of the implants. A temporary bridge is adapted on these abutments at the end of the procedure.

7 – End of procedure panoramic X-ray – 2 inLink® abutments have been screwed onto Axiom® BL implants, Bone Level on distal and two Axiom® TL
implants, Tissue Level have been placed in 12 and 22.

8 – At 3 months, the gums look very good thanks to our autologous bone replacement material and APRF.

9 – Once the gum levels are stabilised, we prefer to place 3.5 mm inLink® abutments (on the right) on the distal implants instead of the 2.5 mm abutments, thus facilitating the maintenance
of the future bridge.

10 – Clinical view with new abutments which are slightly supragingival.

11 – The 360° rotation allows easy orientation of temporary abutments in order to optimise the emergence of access channels. The temporary
bridge is installed on these new abutments.

12 – 13 – Recalibration and aesthetic evaluation.

13 – Aesthetic evaluation.

14 – CAD concept image of the Simeda® frame: the screw channels in yellow and implant axes in blue show the angulation of the screw channels.

15 – 16 – Simeda® ceramic bridge on titanium frame.Despite the sharp inclination of the implants, the screw channels for the locks emerge adequately without weakening the ceramic.

16 – Ceramic bridge. A guiding lock is being used to aid its placement.

17 – The ceramic bridge is placed.

18 – Quality of gum health at 10 months.

19 – Panoramic follow-up X-ray 10 months after implant placement.

20 – Retro-alveolar X-ray follow-up 10 months after surgery. The bone tissue looks excellent.

20 – Retro-alveolar X-ray follow-up 10 months after surgery. The bone tissue looks excellent.

20 – Retro-alveolar X-ray follow-up 10 months after surgery. The bone tissue looks excellent.

21 – Final smile.

Conclusion

For this type of indication, Axiom® Multi Level® has been particularly helpful:
• the inLink® connection with a fixation lock permits very important corrections of implant axes divergences and gives the option to angulate the screw channel up to 25° to choose the emergence of their access channels
• the 360° abutment rotation facilitates their placement during the surgical phase and the processing of the prosthetic part
• bridge handling is facilitated by the fixation locks integrated in the frame