D I G I TA L I M P L A N T O L O G Y About the author Dr. Anthony Mak Dr. Anthony Mak obtained his Bachelor of Dental Surgery from Sydney University and then went to complete his Post Graduate Diploma in Clinical Dentistry (Oral Implants). He graduated with multiple awards and since then has worked with some of Sydney's most renowned practitioners. His interests lie in dental technologies and advances in materials and techniques. He has a unique understanding in CAD/CAM Digital dentistry and currently runs two practices in metropolitan Sydney focusing on comprehensive and implant dentistry. Anthony has a through understanding of direct vs indirect dental restorations and has lectured locally at various study clubs. Case information A patient in his early 80s presented with the chief complaint of recurrent pain, discomfort and swelling from his lower dentition. An examination revealed moderate to advanced bone loss of her remaining mandibular teeth. Peri-apical radiolucencies associated with chronic apical periodontitis were also diagnosed on the lower anterior segment. His lower dentition at the time of presentation was restored with fixed crown and bridge prosthesis with implant fixtures on the 37 and 47 site, placed 20 years prior. The implant fixtures were abutments for fixed bridges that were linked to natural teeth abutments. The patient's health history was unremarkable. The patient requested for his lower dentition to be rehabilitated with the use of dental implants due to his good perception of longevity stemming from his past treatment experience. It was the patient's brief and request that the procedure be simple and not time consuming due to several factors. These factors included: In treatment planning the case, the following criteria were established with the goal of delivering a fixed implant retained provisional bridge. 1. To deliver the complete treatment process in 3 appointments with the appointments being: i. The consultation and treatment planning phase utilising intraoral scanning with the 3-Shape scanner, BioHorizons's Digital Library, 3-Shape implant Studio and a CBCT from Instrumentarium Maxio OP ii. Extraction of all lower natural teeth and immediate placement of implant fixtures utilising a fully guided surgical placement protocol. An intra-oral scan will then be completed utilising implant scan markers to allow the fabrication of the provisional prosthesis. iii. Delivery of a fixed provisional implant retained bridge. 2. To deliver the planned treatment utilising a full digital protocol without the use of conventional impression techniques. 3. For implant surgery to be fully guided keeping the surgical procedure simple, accurate with minimal trauma and discomfort. Treatment description 1. His struggle to keep his mouth open for long periods of time. 2. Difficulty in tolerating conventional impression techniques. 3. His perceived age and health status. Full Consent from Patient and daughter. Orders 1 3 0 0 6 5 8 8 2 2 21