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CAD/CAM international magazine of digital dentistry

I 31 industry report _ single-tooth implants I CAD/CAM 3_2012 This allows for adequate dimensioning of the crown on the one hand, and provides sufficient labial tissue volume on the other. The implant site was prepared for a XiVE S plus (3.8 mm in diameter, 15 mm in lenght) implant. By involving the palatal cortical bone and bone- specific preparation afforded by XiVE and the condensing thread of the implant, we achieved atorqueof50Ncmduringinsertion.Afterplacing the XiVE implant in its final position, an approxi- mately 2 mm wide gap remained to the Lamina vestibularis (Fig. 6). We mixed the drill cuttings collected with a bone trap, which is standard pro- cedure, with a xenogeneic bone grafting material and filled the defect. As a means of protection, we covered it with a correspondingly trimmed absorbable mem- brane. This was covered with a gingival graft from the palatal mucosa, and the flap was re- positioned and sutured (absorbable sutures 4.0; Figs. 7 & 8). As during the first intervention, Amoxicillin (Augmentin 1,000 mg) was given as antibiotic cover and chlorhexidine mouthwash solution and naproxen sodium (Apranax 275 mg) to be taken as required. Healing progressed with- out problems. Six months later and following successful os- seointegration, uncovery was done using a scal- pel (Figs. 9–11). The TempBase (DENTSPLY Friadent), which was used as placement head and replaced withacoverscrewafterinsertion,wasre-inserted and temporarily restored with an appropriate chairside-modified TempBase Cap (Fig. 12). The transition between the plastic cap and the previ- ously prepared temporary crown was filled with composite material. During placement of the temporary crown, pressure was exerted on the underlying soft tissue and the papillae until the region became ischemic (Fig. 13). This condition needs to be reversible, and it is essential to check that the tissue regains its red colouring after a few min- utes. In our experience, this method achieves proliferation of the papillae coronally. After four weeks, the temporary crown was removed and replaced with a transfer coping and the impression was made using a type I polyvinyl- siloxane. The resulting ceramic crown manufactured in the laboratory was bonded to the matching CERCON abutment (DENTSPLY Friadent) using a light-cure adhesive after try-in (Fig. 14). After Fig. 13_The temporary crown, fabricated chairside and modified on the basis of the TempBase Cap, is pressed into position on the surrounding soft tissues. Fig. 14_Fitting of the laboratory- customised CERCON abutment. Fig. 15_Final ceramic crown in situ adapts harmoniously to the overall picture. Fig. 16_X-ray follow-up after three years demonstrates largely stable bone conditions. Fig. 16Fig. 15 Fig. 14Fig. 13