| Abstract | Pacijentica (55 godina) se javila u ordinaciju dentalne medicine kako bi riješila probleme u donjoj čeljusti. Pri inicijalnom pregledu uočena je povećana pokretljivost preostalih zuba. Uspostavljana dijagnoza temeljena je na anamnezi, kliničkom pregledu i radiološkoj dijagnostici. Predloženo je da se preostali parodontološki kompromitirani zubi ekstrahiraju te se pristupi ugradnji četiriju implantata prema Straumann Pro Arch protokolu. Straumann® Pro Arch koncept fiksnog protetskog rješenja za bezube čeljusti predstavlja personalizirani protokol u kojemu postoje uvjeti da se ugrade 4, 6 ili 8 implantata. U ovom prikazu slučaja korištena su četiri Straumann® BLT implantata (3.3 mm NC, SLActive, 12 mm, Roxolid). Planiranje implantacije i simulacije
provedeni su coDiagnostiX® softverom. CT-podaci (DICOM-format) uvezeni su u softver koji je zatim korišten za virtualno postavljanje i njihovu procjenu u trodimenzionalnom prikazu. Uzeti su situacijski otisci i visina međučeljusnih odnosa te se pristupilo oralnokirurškom zahvatu. U istoj posjeti napravljena je ekstrakcija zuba te su imedijatno ugrađena četiri implantata, a pacijentica je istog dana zbrinuta s privremenim mobilnim nadomjeskom. Četiri mjeseca nakon ugradnje implantata učinjena je kontrolna 2D-snimka kako bi se provjerilo stanje ugrađenih implantata te se pristupilo otvaranju implantata i postavljanju nadogradnja za cijeljenje. Privremeni protetski nadomjestak prilagođen je novoj situaciji. Dva tjedna poslije uzet je definitivni otisak čeljusti, a za tri tjedna pacijentici je predan Pro Arch fiksni rad u metal-keramici. Prva kontrola obavljena je nakon dva tjedna, a druga nakon šest mjeseci. Na posljednjoj redovnoj kontroli godinu dana nakon ugradnje implantata zabilježena je odlična oralna higijena i održavanje implanto-protetskog nadomjeska. Pacijentica je navela izrazito zadovoljstvo cijelim postupkom, najviše zbog povećanja žvačne učinkovitosti, što je utjecalo na bolju kvalitetu života. Cilj ovog rada bio je prikaz mogućnost vraćnja pacijentici estetike i funkcije korištenjem digitalnih protokola, na jednostavan i predvidljiv način. |
| Abstract (english) | A 55-year-old female patient visited the dental office seeking a solution for her lower jaw problems. During the initial examination, increased mobility of the remaining teeth was observed. The established diagnosis was based on anamnesis, clinical examination, and radiologic diagnosis. A proposal was made to extract the remaining periodontologically compromised teeth and proceed with inserting four implants according to the Straumann Pro Arch protocol. Straumann® Pro Arch fixed prosthetic solutions enable personalized treatment protocols, where there are conditions to insert 4, 6, or 8 implants into the jawbone. In this case report, Straumann® BLT implants (3.3 mm NC, SLActive, 12 mm, Roxolid) were used. The implant planning and simulations were conducted using coDiagnostiX software. CT data (DICOM format) into the software were imported, enabling the virtual placement in a three-dimensional representation. Situational impressions were taken, and intermaxillary relations were established, initiating the oral surgical procedure. During the same visit, teeth were extracted, and the patient was provided with a temporary removable prosthesis on the same day. Four months after implant installation, a control was performed in 2D to assess the status of the inserted implants. They were uncovered with the placement of gingiva formers. The temporary prosthetic replacement was adjusted to fit the new situation. Two weeks later, a definitive impression of the jaw was taken, and after three weeks, the patient received the Pro Arch fixed restoration in metal ceramic. The first follow-up appointment was scheduled two weeks after the placement of the final prosthetic replacement and the second was scheduled six months after. During the last regular check-up one year after the implant insertion, the patient exhibited excellent oral hygiene. The patient expressed extreme satisfaction with the entire procedure, primarily due to the improved masticatory efficiency, which resulted in a better quality of life. The goal of our work was to show, based on a clinical example with use of digital protocols completely restores the function and aesthetics of the
patient´s in easy and more precise way. |
