Case Report :Traumatized anterior tooth implant restoration
using Oneguide system(TSIII) & temporary abutment
Dr. Hyeon Seong Son , DMD
Department of prosthodontics, Kyunghee university dental hospital

Patient Informations

Treatment Plan

• Age / Sex : 29/ M• CC : Crown fracture on #22(Traumatized 2wks. Ago)

• PI : Crown fracture on #22
c Mo(++), P/R(+), RCT(+)
c Bone resorption (+)• Dx : N/S

BeforeAfter

Crown fracture on #22 & Ext. of #22#22i implant restoration(Titanium abutment & monolithic zirconia)

Clinical Procedures1)
2)
3)
4)

After

BeforeCrown fracture &Chronic periodontitis on #22#22 Flexible denture delivery(Temporary prosthesis)

2 weeks after extraction of #22

Extraction of #22
Implantation & GBR on #22i
Provisional restoration (temporary abutment)
Definitive restoration(titianium abutment & monolithic zirconia)#22i implant restoration

Implant surgical guide planning(Osstem Oneguide)

Implantation & Bone graft(TSIII BA Ø4.5 x 10mm & A-Oss, Ossguide)

Post-op.(1st surgery)

Oneguide try-in

Implant surgical drilling

Post-op.(2nd surgery)

Impression for provisional restoration(polyvinyl siloxane)

Provisional prosthesis fabrication(Temporary abutment + PMMA crown)

Customizing pick-up impression coping

Pick-up impression with a customized impression coping(polyvinyl siloxane)

Provisional prosthesis delivery

Cast for definitive prosthesis fabrication

Customized abutment(anodized in yellow) & Shade takingConclusion

Definitive prosthesis delivery(monolithic zirconia)• Implantation (TSIII BA) on #22i using OneGuide: Additional bone graft with A-Oss and OssGuide on the top of implants (#22i)• Prosthodontic treatment on #22i
: Using a temporary abutment facilitated the aesthetic contouring of the gingiva, including subcritical contour.
: By customizing stock impression coping with acrylic resin, it was possible to fabricate a definitive prosthesis with a subcriticalcontour similar to that of the provisional prosthesis.

Rehabilitation of the atrophic mandiblewith Osstem extra-short implants
Dr. Seokyoung Jang, DDS, MSD
Seoul The Top dental clinic

••••
•

1-

2TSIIITSIIITSIII–••-××××××7×

Case Report :Implantation(TSIII BA)
in partially edentulous maxilla
with severe sinus pneumatization

SpeakerDr. Seungmin Park. DDS, MSD
Seoulplant dental clinic

Patient Informations

Treatment Plan•••••

1) Implantation on #12, 13, 14, 15, 16, 22, 23, 24,25, 26 with sinus lift using lateral approach2) PMMA prosthodontic treatment

Age / Sex : 67/ male
Tooth Number : #12, 13, 14, 15, 16, 22, 23, 24, 25, 26
CC : Discomfort on using RPD
PI : partially edentulous maxilla with severe pneumatization
Dx : partially edentulous maxilla

3) PFM prosthodontic treatment

AfterBeforeAfterBefore

Clinical Procedures#12 area#13 area#15 area#16 area#25 area#26 area

CBCT view of #12-16

Implantation(BA) on #12, 13, 14, 15, 16– sinus lift using lateral approach#22 area

Implantation(BA) on #22, 23, 24, 25,26– sinus lift using lateral approach

2nd surgery - healing abutment
5 months after 1st surgery#14 area#23 area#24 area

CBCT view of #22-26

VD determination using copy of temporary denture
manufactured by 3D printerDelivery of PMMA prosthodontics- using 2 months

6 months after 1st sugery (lateral approach)- Panoramic view

Delivery of PFM prosthodontics on #24, 25, 26- CT view

Conclusion• First stage implant surgery on #12, 13, 14, 15, 16, 22, 23, 24, 25, 26 was performed using TSIII BA with sinus lift.
Lateral approach for the open-window method using round bur and for sinus lifting with placement of allograft (SureOss) wascarried out• Second stage implant surgery was performed 5 months after 1st sugery• PMMA prosthodontic treatment for 2 months.
• PFM prosthodontic treatment on #24, 25, 26

Case Report :Full mouth rehabilitation using Osstem implant system-BADr. Kyeongtae Kim , DDS, MSD,
Seoul daol dental clinic

Patient Information• Age / Sex : 60 / male
• Tooth Number : Full arch
• CC : Tooth fracture & missing
w/ pain.

Treatment Plan
• PI : #14, 15, 24, 25 retained root.
#13-23, 32-35, 43-46 chronic
complex periodontitis.
#16, 17, 26, 27, 37, 47 missing.
• Dx : Missing. Root caries. Chronic
complex periodontitis.

After

BeforeAfter

Before1) Extraction of all teeth
2) Implantation #13-17, 23-27, 33-37, 43-47
3) Full mouth rehabilitation

Clinical Procedures
1) Impression for temporary denture(upper, lower)2) Extraction of all teeth
3) Temporary denture delivery4) Simulation of implantation w/ CT• Implantation of all implant –BA( upper 8 : #13, 14, 15, 17, 23, 24, 26, 27 )( lower 8 : #33, 34, 36, 37, 43, 44, 46, 47 )• Implantation w/ GBR using OssGuide, Sure-oss, A-oss• Implantation w/ sinus lift using CAS kit.
(bone graft material : Sure oss)

1. Temporary denture scanning & Occlusal plane and Vertical dimension check
2. Pick up impression of all implant (exception of #17, ISQ value 67/67)
3. Delivery of Temporary Crown(PMMA)
4. Using Temporary Crown & occlusal adjustment for 3weeks
5. #17 ISQ value 74/71. Pick up impression of all implant for final prosthetics• Waiting for 4 months after implantation• Measure ISQ value• Delivery of final prosthetics(Custom abut, Zirconia Cr.)

BeforeBefore

After

After

BeforeAfterConclusion• Implantation of full mouth(BA) & full mouth rehabilitation: bone graft material(Sure-oss, A-oss, OssGuide), Sinus kit(CAS kit)
• Improve severe overjet bite & appearance with prosthetics: protrusive upper lip, upper teeth before treatment / WNL after treatment: exposed root & malocclusion before treatment / WNL after treatment

Improveoverjet &appearance w/prosthetics

Case Report :Implantation (BA) using OneGuide
After extraction of #37, 38 teeth with periapical lesion- 8 months follow up
Dr. Jong Kyu Lee, DDS, AGD, MSD
SeoulPuReunByul Dental Clinic

Patient Informations• Age / Sex : 54 / Male
• Tooth Number : #37• CC : Pain and gingival swellingon Left Lower molar area

Treatment Plan
• PI : Periapical lesion with alveolarbone destruction• Dx : Periapical abscess of #37, 38
with root fracture of #37

1) Extraction of #37, 38 with curettage anddelayed implantation after 6 months
2) Implantation on #37 using OneGuide

BeforeAfter

BeforeAfter<22-04-28>
Pain & Gingival swelling on #37, 38 area

<22-10-22>
Implantation on #37 with healing abutment<22-04-28> Periapical abscessof #37, 38 with root fx. of #37<23-08-05> 8 months follow up
Implant prosthodontics on #37

Clinical Procedures

Panoramic view<22-04-28> Before extraction<22-04-28> Before extraction - CBCT view<22-05-10> Extraction of #37, 38 and curettage of pa lesion<22-08-27> 3.5 months after extraction - CBCT viewConclusion<22-10-13> OneGuide design on #37<22-10-22> Implantation on #37 using OneGuide• No socket preservation after extraction of teeth (#37 & #38)
: Consideration for risk of infection because of remained severe inflammation near Inferior Alveolar Nerve• Implantation (TSIII BA

5.0 x 7mm) on #37 using OneGuide – 6 months after extraction: Flapless surgery and no bone graft around the implant• Prosthodontic on #37i
: 6 months after extraction & 2 months after placement of implant

Case Report :Digitalized ‘All-on-4’ restoration using multiabutment(straight/angled) & TS multi scan body
- 9 months follow up.
Dr. Sung Woo Ju , DMD
Department of prosthodontics, Kyunghee university dental hospital

Patient Informations

Treatment Plan• Age / Sex : 48/ M• PI : Severe bone resorption on Mx.
1) Extraction of #31,32,33,34,41,42,43, #23i
• CC : Discomfort of previous
Anterior, Mn. Posterior alveolar ridge 2) Implantation on #32,34,42,44
prostheses & Aesthetic dissatisfaction •& Periodontitis on #34-43
3) Mx. : Complete denture(Ivotion)• Dx : Complete denture on Mx.,
Mn. : Monolithic zirconia ‘All-on-4’ restoration
using multi abutment (straight / 17º angled)
Removable partial denture on Mn.

BeforeAfter

BeforeAfter

Chronic periodontitis on #34-43

Complete denture on maxilla‘All-on-4’ restoration on mandible

Chronic periodontitis on #34-43& peri-implantitis on #23i

Complete denture on maxilla‘All-on-4’ restoration on mandible- Multi abutment(straight, 17º angled)

Clinical Procedures

Duplicate denture

Interim denture delivery(3d printing)

Digitalized interim denture fabrication
with facial scanning data

Extraction of #34-43, #23i
& alveoloplasty on sharp Mn. anterior ridge
T - shaped marker(radiopaque flowable resin)

CBCT

#43i

Ø4.5 x 10mm#41i

Ø4.0 x 10mm#31i

Ø4.0 x 10mm

#33i

Anchor screwØ4.5 x 10mm

Implant surgical guide planning (dual scanning protocol)

1) Fixing surgical guide with anchor screw

2-piece implant surgical guide (Osstem OneGuide)

Multi abutment

TS multi scanbody

2) Connecting multi abutment
after implantation (TSIII BA)

3) Connecting TS scan body4) Rubber(PVS) impression
using duplicate denture

Desktop
ScannerRubber impression

3d scan data
Designing prosthesis using a dental CAD software

Impression scanning for prostheses design
Pre - treatment

Pre - treatment

Post - treatment

Post- treatment

Conclusion

Definitive prostheses fabrication

Photograph of pre- & post- treatment (intra-oral &extra-oral)• Through the OneGuide system, it was possible to place implants(TSIII BA) at the planned position considering the final prosthesis.
• Using multi abutment allows for compensation of implant angulation and facilitates the fabrication of screw-retained prosthesis.
• The impression taking using the duplicate denture and TS multi scan body allows for the simultaneous acquisition of impressions andinterocclusal relationship. That enables transitioning the functionality and aesthetics of interim denture into final prosthesis.
• Through the utilization of facial scanning and digital complete denture, we can design prosthetic restorations while directly
considering the patient's facial features, resulting in more aesthetically pleasing outcomes.

A randomized controlled trial of immediate implant
placement comparing hydroxyapatite nano-coatedand uncoated sandblasted/acid-etched implants
using a digital surgical guideYoung-Chang Ko*, Dongseob Lee, Ki-Tae Koo, Yang-Jo Seol, Yong-Moo Lee, Jungwon Lee
Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea

Introduction

Results

Hydroxyapatite (HA) shares a similar composition with humanbone, which has led to its long-standing use as a coating material
for implant surfaces (de Groot et al., 1987; Ong & Chan, 2017;Thomas et al., 1987). However, during long-term follow-up, a highrate of implant failure has been reported. This is attributed to theweak adhesive strength of HA to the implant surface and thedetachment of the adhered HA layer, which is often due to therelative thickness of the HA layer (Liao et al., 1997; Wheeler,1996; Whitehead et al., 1993). With the advancement oftechnology, improvements have been made in adhesive strengthand the ability to coat nano-level layers. Consequently, dental
implants coated with biomaterials have become increasingly
utilized.

In total, 48 implants (test; n=24, control; n=24) in 37 patients (test;n=19, control; n=18) were analyzed. Despite no significant
between-group difference at surgery, the test group showed higher
ISQ values than the control group at 2 (76.53 ± 4.17 vs. 71.32 ±
4.79, p<0.01), 3 (77.45 ± 4.41 vs. 73.85 ± 4.69, p<0.05), and 4
months (79.08 ± 2.96 vs. 73.43 ± 3.52, p<0.0001) postoperatively.
The ISQ at implant surgery was influenced by age and diabetes
mellitus (DM) at the implant level and DM and predicted totalbone-to-implant contact area at the patient level.

PurposeThis paper presents the interim results at the 4-month mark after
immediate implant placement, including a comparison of HA nanocoated SLA implants and uncoated SLA-surface implants in termsof implant stability, volumetric changes, and patient-reported
outcome measures (PROMs). These factors will be examined in a
10-year prospective clinical trial.

Table 1. Multivariable linear regression
analysis of ISQ value at implant surgery.
Continuous variables of site level factors
were considered in this analysis.

Material and methods

NA: The variable was excluded in theanalysis due to multicollinearity with otherincluded variables.

Forty patients were recruited and randomly allocated to an HA
nano-coated SLA group (test, Osstem TSIII BA, n=20) and an
uncoated SLA group (control, Osstem TSIII SA, n=20) using
single-blinded/block randomization. Following nontraumatic
extraction of the maxillary posterior teeth, implants wereimmediately placed using a prefabricated digital surgical guide, andbone grafting (Osstem A-Oss) with/without sinus augmentation
was conducted. Insertion torque and implant stability quotient(ISQ) were measured at implant surgery and 1, 2, 3, and 4 months
postoperatively. Intraoral scans, PROMs and soft tissue
inflammation data were collected to assess ridge volume changes
and patient satisfaction, and multivariable linear regression analysisof ISQ was performed.

Figure 6. Implant stability between thetest and control groups. Implantstability quotient (ISQ) values weremeasured at implant surgery day and 1,2, 3, and 4 months after surgery.

PPD, probing pocket depth; REC, recession
depth; CAL, clinical attachment level; PBAT, predicted total bone-to-implant contact
area; PBA-D1/D2, predicted D1/D2 boneto-implant contact area.

Figure 7. Intragroup and intergroupcomparisons for vertical deviations in
buccal and palatal sides.

Figure 8. Intragroup and intergroupcomparisons for volume changes on thebuccal and palatal sides.

Figure 9. Visual analog scales (VAS) scores for pain, feeling of swelling at surgery,discomfort with the implant placement procedure, implant surgery satisfaction, andwillingness to receive treatment

Figure 1. CONSORT flowchart.

Figure 2. Macroscopic and scanning electron Figure 3. Flow of the digital
microscopy (SEM) images.
surgical guide protocol.

Figure 10. The results of Oral Health Impact Profile-14 (OHIP-14) for seven domains.

Figure 11. Comparisons of the soft tissue inflammationindex between the test and control groups at 1 (V4) and 4(V5) weeks after implant surgery.

ConclusionFigure 4. Overall surgical procedures.
Figure5.
Theoutlineofmeasurements of vertical deviationsand volume changes before andafter surgery.

HA nano-coated SLA implants promoted bone formation during theearly osseointegration phase and displayed favorable implantstability in poor bone conditions compared to uncoated SLA
implants.