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ePaper created 2014-11-20, 16:14:55 | version 1.30.01
case report _ CAD/CAM restorations I plantation. Finally, tooth 26 was extracted and im- plantation followed 12 weeks later (4.3 mm × 9 mm CAMLOG implants; Figs. 2–4). We decided against closedhealingandtheimplantwasclosedwithaflat gingivaformer(2mm).Withthis,afurtheroperation to expose the implant could be avoided. Chairsideworkflow Ten weeks after implantation, the prosthetic restoration was performed in one session without a physical model. A digital impression was taken by means of CEREC Bluecam (Sirona Dental Systems). Sincenoexposureoftheimplantswasnecessaryand therewerenoopenwoundedges,wewereabletouse the powder for the scanning procedure without any concerns (Fig. 5). After the insertion of the CAMLOG TiBase (Sirona Dental Systems; Fig. 6), which served asthetitaniumadhesiveabutmentforthechairside- manufactured hybrid abutment crown made of lithium disilicate (IPS e.max, Ivoclar Vivadent), the appropriatescanbody(SironaDentalSystems;Fig.7) was placed on the TiBase. Before taking the impres- sion, the placement of the TiBase was radiologically controlled (Fig. 8). The virtual construction was created by means of CEREC Software 4.2 (Sirona Dental Systems) and was built up similar to the crown’s construction. An advantage of the virtual construction is the more flexible control of the emergence profile. The pressure on the gingiva can be adjusted individually, and displacements of about 5 mm have proven to be unproblematic. Further parameters, such as minimum strength and position of the screw channels, should be ad- justed and included in the construction according to themanufacturer’sinstructions.Themanufactureof the hybrid abutment crown was achieved with the CEREC MC XL milling unit (Sirona Dental Systems; Fig. 9). After the colour determination, the low translucency A2 A16 (L) ceramic block was selected. After glazing and colouring, the crystallisation or combination firing was done (Programat CS, Ivoclar Vivadent). The monolithic polished abutment crown was then extra-orally attached (Multilink Hybrid Abutment, Ivoclar Vivadent) to the TiBase (Fig. 10). The hybrid abutment crown was screwed in and the I 17CAD/CAM 4_2014 Fig. 4_Four weeks after implantation. Fig. 5_The situation before the digital impression. Fig. 6_CAMLOG TiBase. Fig. 7_Preparation for the digital impression. Fig. 8_Radiological control of the TiBase. Fig. 9_The hybrid abutment produced by the milling unit. Fig. 10_The hybrid abutment crown with luting composite. Fig. 6 Fig. 7 Fig. 4 Fig. 5 Fig. 8 Fig. 10Fig. 9 CAD0414_16-19_Baysal 14.11.14 13:53 Seite 2 CAD0414_16-19_Baysal 14.11.1413:53 Seite 2