Case Report: Immediate loading of both upper and lower jaw in one visit
Technology: Immediate Smile® bridge: CAD/CAM restorations for immediate loading – Learn More at: SimPlant Go
Case By: Dr. Joshua Campbell and Dr. Thomas Myers 
“The bridges were made based on the scan prosthesis and delivered together with the SurgiGuide, could it be any easier?”
“The precision result with the Immediate Smile® bridge is unmatched. Personally we could not lay a better foundation to deliver the best result possible for the patient. With no more extra work!”
Case Photos and Descriptions
All Photos: Click image for larger view.
All Descriptions: Read for Photos from left to right.
![]](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/09/case1a.png)
1. The conventional upper and lower denture were converted into a scan prosthesis by integrating Dual Scan markers. The Dual Scan module in SimPlant automatically integrates all scans.
2-3. Based on the scan prosthesis, the soft tissue was calculated and a prosthetic set-up was made. Together with the information of the temporary cylinders, the full anatomical bridge was designed.
4. Preview of the bone-supported Navigator SAFE SurgiGuide. For the upper jaw, a mucosa-supported SurgiGuide was made.
![]](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/09/case1b.png)
5. Mucosa-supported Navigator SAFE SurgiGuide.
6. Securing the SurgiGuide with lateral screws.
7. All implants placed with depth control using 3I Navigator implant holders.
8. A mucosa-supported SurgiGuide allows for minimally invasive surgery.
![]](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/09/case1c.png)
9. The Immediate Smile models were mounted in an articulator using the duplicates of the scan prosthesis.
10-11. The Immediate Smile bridges were tried out on the Immediate Smile model to check both occlusion and articulation.
12. Occlusal view of the Immediate Smile bridge in the upper jaw.
![]](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/09/case1d.png)
13. Occlusal view of the Immediate Smile bridge in the lower jaw.
14. The bridge is placed and the patient is asked to realize maximal occlusion. Here, the upper denture is used as an antagonist. The cylinders are not yet secured, allowing the bridge to align itself into the correct occlusion. With this procedure, you avoid time-consuming adjustments of the occlusion.
15. The temporary cylinders are secured onto the bridge by injecting SmartCem2 composite luting cement.
16. The cylinders are secured one by one through light-curing.
![]](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/09/case1e.png)
17. Placement of the Immediate Smile bridge in the upper jaw.
18.The temporary cylinders are secured onto the bridge by injecting SmartCem2 composite luting cement.
19. The cylinders are secured one by one through light-curing.
20. When all cylinders have been secured, the bridge is removed for further finishing outside the patient’s mouth.
![]](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/09/case1f.png)
21. The remaining cervical gap between the temporary cylinder and bridge is filled with SmartCem2. This ensures a smooth surface for optimal healing of the soft tissue.
22. Finished bridge.
23. Occlusal view of the upper Immediate Smile bridge.
24. Frontal view of finished Immediate Smile bridges in maximal occlusion.
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