Figure 1. - bredent-implants · The provisional crown was then cemented with temporary cement such...
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Topic: Implant insertion after tooth extraction: Clinical outcomes with different approaches References Conclusions Background and Aim IMMEDIATE IMPLANTATION AND LOADING IN THE AESTHETIC ZONE: CASE REPORTS Selim Pamuk*, Aslan Y. Gokbuget, Ozden Haytural PGG Dental Clinic / Istanbul/Turkey 588 Three patients underwent immediate implant placement and immediate provisional restoration with nonocclusal loading in the aesthetic area. Implants placed into the fresh extraction socket using a flapless approach. Flapless implant placement helps to preserve site morphology by protecting and supporting existing hard and soft tissues while minimizing surgical trauma to the adjacent tissues. The Implants that were used Bredent BlueSKY were either 14 mm length were 3.5, 4.0, 4.5 mm in diameter. A SKY temp L abutment was placed and the screw torqued at around 18-20 N cm2, which adequately supported the gingival profile in the first case. The clinical situation was scanned with cerec bluecam and manufactured the provisional crown out of Lava™ Ultimate from 3M Espe. The provisional crown was then cemented with temporary cement such as Tempbond (Figure 1). After 4 months the provisional crown was removed and final preparation was initiated. For digitisation purposes, the SKY uni.fit CAD is placed. The CEREC inLab CAD/CAM system was used to produce the abutment from IPS e-max CAD blocks and the crown was milled from E-max CAD LT (Figure 1). In the second case, after surgery, SKY uni.fit Ti-Base for Cerec is used, and in the third case SKY uni.fit CAD abutment with e-max CAD abutments were placed and the provisional Lava™ Ultimate crown were cemented with provisional cement. The aim was to use this abutment as the final abutment and therefore care was taken to avoid the need to unscrew it during the treatment. After 4 months, the abutments was adjusted in the mouth without removing from the implants according to the final tooth form using a chamfer shaped diamond bur and water spray (Figure 2). To fabricate the ceramic crown, a second digital impression was taken of the previously milled and screwed abutment. The crown was CAD ⁄ CAM fabricated using the IPS e-max CAD LT block and the crown was cemented to the abutment with the same resin cement (Figure 2 and figure 3). Prosthodontic techniques to enhance soft tissue contour by using custom abutments and provisional crowns to support the periimplant mucosa during healing have been described in case reports and retrospective and prospective cohort studies. It was concluded that immediate or immediate-delayed placement of implants is a viable treatment option and may be associated with better outcomes in terms of esthetics and patient satisfaction compared with conventionally placed implants (2,3,5). Immediate provisionalization provides a number of clinical and patient benefits. Reduced chairtime, elimination of additional surgery, immediate nonocclusal loading, bone preservation, and aesthetic benefits are achieved when the patient receives a customized provisional (1,2,3,4) The aim of this study is to preserve anterior aesthetic and function after the tooth extraction by immediately placing a single implant followed by placement of provisional restoration. Dental implant placement with immediate provisionalization is a well- established protocol with excellent success rates. This case report series describes the use of CAD/CAM and conventional Technologies to facilitate the fabrication of provisional and definitive restorations in the aesthetic zone. The aim of this approach is to preserve anterior aesthetic and function after the tooth extraction by immediately placing single implant followed by placement of provisional restoration. Bredent Blue SKY implants were placed into the fresh extraction socket using a flapless approach, and SKY uni.fit Ti-Base for CEREC abutment or SKY uni.fit CAD were used . All cases were digitally scanned with intraoral camera and CAD/CAM is used for fabrication of the crowns. 3M Lava Ultimate was the choice of material for temporary crowns and Ivoclar e-max for definitive ones. All restoration provided the patient with immediate aesthetics, function and comfort without any complications during the healing period. Placement of temporary crown immediately after implant placement reduced overall treatment time and helped to preserve original gingival tissue contour. Flapless implant placement helps to preserve site morphology by protecting and supporting existing hard and soft tissues while minimizing surgical trauma to the adjacent tissues. Abutment customization helps to improve aesthetic in critical anterior zone. Abstract Results Methods and Materials Presented at Figure 1. All restoration provided the patient with immediate esthetics, function and comfort without any complications during the healing period. During the provisional phase, an optimal emergence profile was created by adjusting the provisional restoration. Placement of the temporary implant crown immediately after implant placement reduces overall treatment time, avoids a second stage operation and the original gingival tissue contour can be preserved. We think that customisation of the abutment is required to improve the aesthetics. However, these protocols require careful pre-operative planning and patient selection. Furthermore, good primary implant stability is a prerequisite, in addition to the development of a protected occlusion to create a non-occluding provisional crown. 1. Block M, Finger I, Castellon P, Lirettle D. Single tooth immediate provisional restoration of dental implants: technique and early results. J Oral Maxillofac Surg. 2004;62:1131–1138. 2. Crespi R, et al. Immediate provisionalization of dental implants placed in fresh extraction sockets using a flapless technique. Int J Periodontics Restorative Dent. 2012 Feb;32:29-37. 3. Degidi M, Daprile G, Nardi D, Piattelli A. Immediate provisionalization of implants placed in fresh extraction sockets using a definitive abutment: the chamber concept. Int J Periodontics Restorative Dent. 2013 Sep- Oct;33:559-65. 4. Jemt T. Restoring the gingival contour by means of provisional resin crowns after single-implant treatment. Int J Periodont Restor Dent. 1999;19:21–29. 5. Tselios N, Parel SM, Jones JD. Immediate placement and immediate provisional abutment modeling in anterior single-tooth implant restorations using a CAD/CAM application: a clinical report. J Prosthet Dent. 2006 Mar;95:181-5. Figure 3. Figure 2.
Transcript of Figure 1. - bredent-implants · The provisional crown was then cemented with temporary cement such...
Topic: Implant insertion after tooth extraction: Clinical outcomes with different approaches
References
Conclusions
Background and Aim
IMMEDIATE IMPLANTATION AND LOADING IN THE AESTHETIC ZONE: CASE REPORTS
Selim Pamuk*, Aslan Y. Gokbuget, Ozden Haytural
PGG Dental Clinic / Istanbul/Turkey
588
Three patients underwent immediate implant placement and immediate provisional restoration with nonocclusal loading in the aesthetic area. Implants placed into the fresh extraction socket using a flapless approach. Flapless implant placement helps to preserve site morphology by protecting and supporting existing hard and soft tissues while minimizing surgical trauma to the adjacent tissues. The Implants that were used Bredent BlueSKY were either 14 mm length were 3.5, 4.0, 4.5 mm in diameter.
A SKY temp L abutment was placed and the screw torqued at around 18-20 N cm2, which adequately supported the gingival profile in the first case. The clinical situation was scanned with cerec bluecam and manufactured the provisional crown out of Lava™ Ultimate from 3M Espe. The provisional crown was then cemented with temporary cement such as Tempbond (Figure 1).
After 4 months the provisional crown was removed and final preparation was initiated. For digitisation purposes, the SKY uni.fit CAD is placed. The CEREC inLab CAD/CAM system was used to produce the abutment from IPS e-max CAD blocks and the crown was milled from E-max CAD LT (Figure 1).
In the second case, after surgery, SKY uni.fit Ti-Base for Cerec is used, and in the third case SKY uni.fit CAD abutment with e-max CAD abutments were placed and the provisional Lava™ Ultimate crown were cemented with provisional cement. The aim was to use this abutment as the final abutment and therefore care was taken to avoid the need to unscrew it during the treatment.
After 4 months, the abutments was adjusted in the mouth without removing from the implants according to the final tooth form using a chamfer shaped diamond bur and water spray (Figure 2).
To fabricate the ceramic crown, a second digital impression was taken of the previously milled and screwed abutment. The crown was CAD ⁄ CAM fabricated using the IPS e-max CAD LT block and the crown was cemented to the abutment with the same resin cement (Figure 2 and figure 3).
Prosthodontic techniques to enhance soft tissue contour by using custom abutments and provisional crowns to support the periimplant mucosa during healing have been described in case reports and retrospective and prospective cohort studies. It was concluded that immediate or immediate-delayed placement of implants is a viable treatment option and may be associated with better outcomes in terms of esthetics and patient satisfaction compared with conventionally placed implants (2,3,5).
Immediate provisionalization provides a number of clinical and patient benefits. Reduced chairtime, elimination of additional surgery, immediate nonocclusal loading, bone preservation, and aesthetic benefits are achieved when the patient receives a customized provisional (1,2,3,4)
The aim of this study is to preserve anterior aesthetic and function after the tooth extraction by immediately placing a single implant followed by placement of provisional restoration.
Dental implant placement with immediate provisionalization is a well-established protocol with excellent success rates. This case report series describes the use of CAD/CAM and conventional Technologies to facilitate the fabrication of provisional and definitive restorations in the aesthetic zone.
The aim of this approach is to preserve anterior aesthetic and function
after the tooth extraction by immediately placing single implant followed by placement of provisional restoration.
Bredent Blue SKY implants were placed into the fresh extraction socket
using a flapless approach, and SKY uni.fit Ti-Base for CEREC abutment or SKY uni.fit CAD were used . All cases were digitally scanned with intraoral camera and CAD/CAM is used for fabrication of the crowns. 3M Lava Ultimate was the choice of material for temporary crowns and Ivoclar e-max for definitive ones.
All restoration provided the patient with immediate aesthetics, function and
comfort without any complications during the healing period. Placement of temporary crown immediately after implant placement reduced overall treatment time and helped to preserve original gingival tissue contour.
Flapless implant placement helps to preserve site morphology by
protecting and supporting existing hard and soft tissues while minimizing surgical trauma to the adjacent tissues. Abutment customization helps to improve aesthetic in critical anterior zone.
Abstract
Results
Methods and Materials
Presented at
Figure 1.
All restoration provided the patient with immediate esthetics, function and comfort without any complications during the healing period. During the provisional phase, an optimal emergence profile was created by adjusting the provisional restoration.
Placement of the temporary implant crown immediately after implant placement reduces overall treatment time, avoids a second stage operation and the original gingival tissue contour can be preserved. We think that customisation of the abutment is required to improve the aesthetics. However, these protocols require careful pre-operative planning and patient selection. Furthermore, good primary implant stability is a prerequisite, in addition to the development of a protected occlusion to create a non-occluding provisional crown.
1. Block M, Finger I, Castellon P, Lirettle D. Single tooth immediate provisional restoration of dental implants: technique and early results. J Oral Maxillofac Surg. 2004;62:1131–1138.
2. Crespi R, et al. Immediate provisionalization of dental implants placed in fresh extraction sockets using a flapless technique. Int J Periodontics Restorative Dent. 2012 Feb;32:29-37.
3. Degidi M, Daprile G, Nardi D, Piattelli A. Immediate provisionalization of implants placed in fresh extraction sockets using a definitive abutment: the chamber concept. Int J Periodontics Restorative Dent. 2013 Sep-Oct;33:559-65.
4. Jemt T. Restoring the gingival contour by means of provisional resin crowns after single-implant treatment. Int J Periodont Restor Dent. 1999;19:21–29.
5. Tselios N, Parel SM, Jones JD. Immediate placement and immediate provisional abutment modeling in anterior single-tooth implant restorations using a CAD/CAM application: a clinical report. J Prosthet Dent. 2006 Mar;95:181-5.
Figure 3.
Figure 2.
