CAD/CAM international magazine of digital dentistry

20 I I case report _ implant prosthetic restoration (GC; Fig. 19). In the next step, the fully anatomical provisional crown was designed using the soft- ware and milled from a lithium disilicate block (Fig. 20). After completion, it was polished to a high gloss (Fig. 21). Placementofthetemporarycrown Subsequently, the mucosa healed around the gingiva former and exhibited a homogeneous, inflammation-free structure (Fig. 22). Prior to the screwing of the TitaniumBase abutment into the XiVEimplant,thescrewchannelwascleanedwith chlorhexidine then dried and the peri-implant mucosa was cleansed. Thepreciseintra-oralpositionoftheabutment was checked using the resin transfer key. Follow- ing this, the optimal position for the temporary crown was also determined by means of the key and the crown was temporarily attached using cement (Fig. 23). The facial view of the opened mouth and the length of the incisal edge conformed to the functional, aesthetic and phonetic requirements (Fig. 24). A well-osseointegrated implant was ev- ident, along with the radiopaque TitaniumBase and superstructure in the final radiologic control (Fig. 25). As the patient was very pleased and as astablematerial,lithiumdisilicate,hadbeenused forthetemporaryrestoration,thepatientinitially did not want a final restoration. _Conclusion The method of implant placement and a graft- ing procedure with bone splitting in a single session described here presents a realistic alter- native to conventional grafting of hard and soft tissue in the aesthetic region. The prerequisite is anadequatehorizontalandverticalbonevolume, in order to make the deep incisions necessary to mobilise the buccal lamella. The removal of bone blocks from additional surgical sites can be dispensed with for the patient. TheXiVEimplant,whichalsoguaranteesprimary stability in weak bone, with its unique, osseoin- tegration-promoting surface and its compressive apical section, made the implant placement in this complicated case predictable, safe and successful._ Editorial note: A complete list of references is available fromtheauthor. Fig. 19_The precise position of the TitaniumBase, which was cemented to the customised abutment, was reproducedbymeansofatransferkey. Fig. 20_The temporary crown was virtually designed using the software and milled from a lithium disilicate block. Fig. 21_The finished, highly polished crown. Fig. 22_The healed peri-implant soft tissue. Fig. 23_The crown, inserted with the aid of the transfer key and temporarily attached using cement. Fig. 24_When the mouth was open, the length of the incisal edge conformed to the functional, aesthetic and phonetic requirements. Fig. 25_The final radiological control shows a well-osseointegrated implant, along with the radiopaque TitaniumBase and superstructure. CAD/CAM 4_2012 Dr Fred Bergmann and Partners Dental Practice Heidelbergerstr.5–7 68519Viernheim Germany FredBergmann@oralchirurgie.com www.oralchirurgie.com CAD/CAM_contact Fig. 21Fig. 19 Fig. 25Fig. 24Fig. 23Fig. 22 Fig. 20