{"id":5211,"date":"2016-01-21T08:47:47","date_gmt":"2016-01-21T01:47:47","guid":{"rendered":"http:\/\/nhakhoadrhung.com\/en\/?p=5211"},"modified":"2018-02-03T08:48:45","modified_gmt":"2018-02-03T01:48:45","slug":"clinical-case-for-all-on-4-implant-placement-2","status":"publish","type":"post","link":"https:\/\/nhakhoadrhung.com\/en\/clinical-case-for-all-on-4-implant-placement-2\/","title":{"rendered":"Clinical Case For All-On-4 Implant Placement 2"},"content":{"rendered":"<p>Mrs T.T.H, 55 years old, has lost all her teeth in the lower arch and had been using removable denture for the past 10 years. However, since the unfit denture resulted in discomfort and poor aesthetics, she came to us to look for another solution.<\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1585 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/anh-benh-nhan-nha-khoa-drhung-200x300.jpg\" alt=\"anh-benh-nhan-nha-khoa-drhung\" width=\"200\" height=\"300\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1586 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/phuc-hinh-tam-tuc-thi-02-300x178.jpg\" alt=\"phuc-hinh-tam-tuc-thi-02\" width=\"300\" height=\"178\" \/><br \/>\nAfter making careful analysis of the patient\u2019s case, we decided to co-operate with associated dental specialists from the US to perform the \u2018All-On-4\u2019 solution with advanced surgical guides. This is the most advanced system which has never been implemented in Vietnam before.<br \/>\nAll-On-4 is a technique in which only 4 implants are required to be placed on one complete edentulous arch, and then a restoration will be placed on these implants. This technique is optimal for cases where there is severe bone deficiency in posterior teeth (to the side of the molars), does not require bone grafting and is more economical for patients.<\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1554 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/all-on-4-nha-khoa-drhung-300x235.jpg\" alt=\"all-on-4-nha-khoa-drhung\" width=\"300\" height=\"235\" \/><br \/>\nOur dental surgeons, prosthodontists and dental technicians at Dr. Hung &amp; Associates Dental Center had been working online with the associate dental specialists in the US to design the surgical guides including 3 guides, which ensured the procedure was performed speedy and accurately. Right after the surgery, patient was applied immediate temporary restoration on implant. At the moment, Mrs. T.T.H is very satisfied with her new teeth.<br \/>\n<img loading=\"lazy\" class=\"size-medium wp-image-1561 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/ham-rang-gia-nhu-that-300x200.jpg\" alt=\"ham-rang-gia-nhu-that\" width=\"300\" height=\"200\" \/><br \/>\nFollowing is the complete procedure of the \u2018All-On-4\u2019 surgery with surgical guides performed at Dr Hung &amp; Associates Dental Center:<\/p>\n<h3>Before the surgery<\/h3>\n<p>&#8211; Physical examination.<br \/>\nPatient: T.T.H, 55 years old<br \/>\nHistory:<br \/>\n+ Upper arch: partial removable denture, for 5 years.<br \/>\n+ Lower arch: complete removable denture, for 5 years.<br \/>\nDiagnosis: lower arch\u2019s denture was loose and unstable due to Residual ridge resorption<\/p>\n<p>Taking CT Cone Beam X-Ray image<\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1564 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/chup-phim-ct-conbeam-nha-khoa-drhung-300x225.jpg\" alt=\"chup-phim-ct-conbeam-nha-khoa-drhung\" width=\"300\" height=\"225\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1587 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/chup-phim-CT-benh-nhan-300x206.jpg\" alt=\"chup-phim-CT-benh-nhan\" width=\"300\" height=\"206\" \/><br \/>\nAfter performing physical examination and basing on the patient\u2019s case, the suggested treatment was an \u2018All-On-4\u2019 with surgical guides (place 4 implants in these following teeth: 32, 35, 42, 45 and apply immediate temporary on implant).<br \/>\n&#8211; Take CTCB with Denture<br \/>\n&#8211; Using data from the CT Cone Beam and Nobel Clinician software to develop the treatment plan.<br \/>\nHowever, our teams noticed that aveolar ridge at teeth position 32, 35, 42, 45 was sharp, small and unlevelled.<br \/>\nTherefore, we decided to whittle the Aveolar ridge of the lower arch to expand the diameter of implants and to facilitate restoration<br \/>\nWorking online with dental specialists in the US, we agreed on the treatment plan and the design of surgical guides.<\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1565 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/chup-CT-drhung-dental-300x225.jpg\" alt=\"chup-CT--drhung-dental\" width=\"300\" height=\"225\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1588 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/scan-ham-gia-benh-nhan-dang-deo-300x203.jpg\" alt=\"scan-ham-gia-benh-nhan-dang-deo\" width=\"300\" height=\"203\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1569 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/thiet-ke-mang-huong-dan-drhung-300x200.jpg\" alt=\"thiet-ke-mang-huong-dan-drhung\" width=\"300\" height=\"200\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1571 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/ke-hoach-dieu-tri-mang-huong-dan-drhung-300x128.jpg\" alt=\"ke-hoach-dieu-tri-mang-huong-dan-drhung\" width=\"300\" height=\"128\" \/><br \/>\nAfter discussions, we decided that surgical guides include 3 guides:<br \/>\n&#8211; The first guide simulated the patient\u2019s denture, fitted her upper arch and was responsible for determinding positions needed to be whittled.<br \/>\n&#8211; The second guide was to check the jawbone ridge after whittled , in order to ensure the arch was flattened and facilitated to place the implants.<br \/>\n&#8211; The third guide indicated the positions of implants. Provisional restoration on implants was designed by CAD\/CAM system to apply immediately after implantation.<br \/>\nTransfer the treatment plan and necessary information to the Laboratory to produce the surgical guides and Provisional restoration on implants<br \/>\nFinal discussion among surgeons about the surgery.<\/p>\n<h3>During the surgery<\/h3>\n<p>Preparation for patient and surgery room.<br \/>\nPatient had a general examination and the surgery was performed with pre-anesthesia and local anesthesia.<br \/>\nSurgery procedure<br \/>\nPlace the first guide then specify 3 positions to fix guides and mark the whittle point.<br \/>\nWhittle as marked, place the second guide with fixed pin to check the whittled arch.<\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1573 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/mang-huong-dan-phau-thuat-thu-nhat-dr-hung-300x225.jpg\" alt=\"mang-huong-dan-phau-thuat-thu-nhat-dr-hung\" width=\"300\" height=\"225\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1575 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/danh-dau-cac-vi-tri-mai-xuong-300x149.jpg\" alt=\"danh-dau-cac-vi-tri-mai-xuong\" width=\"300\" height=\"149\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1578 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/mang-huong-dan-thu-2-drhung-300x225.jpg\" alt=\"mang-huong-dan-thu-2-drhung\" width=\"300\" height=\"225\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1579 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/kiem-tra-bo-xuong-sau-khi-mai-300x240.jpg\" alt=\"kiem-tra-bo-xuong-sau-khi-mai\" width=\"300\" height=\"240\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1582 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/mang-huong-dan-thu-3-drhung-300x225.jpg\" alt=\"mang-huong-dan-thu-3-drhung\" width=\"300\" height=\"225\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1584 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/cam-implant-theo-ke-hoach-dieu-tri-300x236.jpg\" alt=\"cam-implant-theo-ke-hoach-dieu-tri\" width=\"300\" height=\"236\" \/>Place the third guide to implant: 4 holes were drilled and 4 implants were placed at the exact position according to the surgical guide.<\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1591 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/khoan-tao-lo-300x188.jpg\" alt=\"khoan-tao-lo\" width=\"300\" height=\"188\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1592 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/khoan-tao-lo-2-300x188.jpg\" alt=\"khoan-tao-lo-2\" width=\"300\" height=\"188\" \/><br \/>\nFinally, immediate loading on implant was applied.<\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1593 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/khoan-tao-lo-3-300x195.jpg\" alt=\"khoan-tao-lo-3\" width=\"300\" height=\"195\" \/><\/p>\n<p><img loading=\"lazy\" class=\"size-medium wp-image-1595 aligncenter\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/phuc-hinh-tam-tuc-thi-02-1-300x178.jpg\" alt=\"phuc-hinh-tam-tuc-thi-02\" width=\"300\" height=\"178\" \/><\/p>\n<h3>After the surgery<\/h3>\n<p>Result:<\/p>\n<p>Surgery duration: 1 hour 45 minutes.<br \/>\nMinimum invading.<br \/>\nSurgery was performed precisely according to the treatment plan.<br \/>\nImmediate loading on implant produced by CAD\/CAM system was applied promptly and accurately after the surgery.<br \/>\nThe patient\u2019s overall health condition was good and stable.<br \/>\nThe patient and doctors are both satisfied with the treatment result.<br \/>\nPatient is scheduled to have regular dental examination to check the healing status. After 10 days, the wound had completely healed and stitches were removed. Loading on implants functioned properly and aesthetically guaranteed.<br \/>\nAfter 6 months, permanent prosthesis will be placed.<\/p>\n<h3>Conclusion<\/h3>\n<p>Treatment using the CAD\/CAM system has made the process faster, less invading and more accurate.<br \/>\n<img loading=\"lazy\" class=\"aligncenter wp-image-1676 size-full\" src=\"http:\/\/nhakhoadrhung.com\/wp-content\/uploads\/2016\/01\/ca-lam-sang-all-on-4.jpg\" alt=\"ca-lam-sang-all-on-4\" width=\"680\" height=\"330\" \/><br \/>\nImplementing restoration with guided implantation surgery in oder to ensure aesthetics and functions of restoration.<br \/>\nAt Dr Hung &amp; Associates Dental Center, with the team work performing and tightly co-operation between all surgeons, prosthodontists and Lab-in-house techinicians, along with the most advanced technologies and equipments, we proudly provide our patients with only best qualified treatments, completely comparable with countries who has developed dental systems around the world.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Mrs T.T.H, 55 years old, has lost all her teeth in the lower arch and had been using removable denture for the past 10 years. However, since the unfit denture resulted in discomfort and poor aesthetics, she came to us to look for another solution. After making careful analysis of the patient\u2019s case, we decided [&#8230;]\n","protected":false},"author":16,"featured_media":2956,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[91,95],"tags":[],"yst_prominent_words":[],"_links":{"self":[{"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/posts\/5211\/"}],"collection":[{"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/posts\/"}],"about":[{"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/types\/post\/"}],"author":[{"embeddable":true,"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/users\/16\/"}],"replies":[{"embeddable":true,"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/comments\/?post=5211"}],"version-history":[{"count":1,"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/posts\/5211\/revisions\/"}],"predecessor-version":[{"id":5212,"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/posts\/5211\/revisions\/5212\/"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/media\/2956\/"}],"wp:attachment":[{"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/media\/?parent=5211"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/categories\/?post=5211"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/tags\/?post=5211"},{"taxonomy":"yst_prominent_words","embeddable":true,"href":"https:\/\/nhakhoadrhung.com\/en\/wp-json\/wp\/v2\/yst_prominent_words\/?post=5211"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}