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cosmetic dentistry_ beauty & science International Edition

I 37 case report _ impression of steeply angulated implants I cosmeticdentistry 1_2015 proximity to another tooth or the natural teeth. Although rather rare, these situations render im- pression taking and the consequent restoration of the placed implants difficult.3, 4 In the present case report, a method to allow for treatment in such a situation is described. _Case report A 60-year-old male patient reported to our office for restoration of two implants placed in regions 29 and 30 three months earlier at a dif- ferent office (Fig. 1). According to the records obtained from the previous treating dentist, a surgical guide was not used when placing the implants. Implant 29 had been placed at an inadequate angle.Owingtotheangulationoftheimplant,the simultaneous placement of two impression posts was not possible, rendering it impossible to take an impression (Fig. 2). Since the implant was placed in proximity to the inferior alveolar nerve, removal of the inte- grated implant was not advisable. The following approach was used to solve this problem: _Implant 30 presented with a minor mesial tilt. Therefore, a prefabricated impression post, together with the corresponding impression coping, could be placed (Fig. 3). Fig. 4_The 25-degree angulated abutment used. Fig.5_CAD/CAM-fabricatedimpression coping placed on the abutment. Fig. 6_The coping covered with resin to increase retention. Fig. 7_Impression posts with copings in place. Fig. 8_Impression with implant analogues in place. Fig. 9_Custom-made abutments in place on the cast. Fig. 10_Metal–ceramic crowns in place on the cast. Fig. 11_Panoramic radiographs with the abutments in place. Fig. 12_The final restorations in place. Fig. 4 Fig. 6 Fig. 10 Fig. 12 Fig. 7 Fig. 9 Fig. 5 Fig. 8 Fig. 11 CDE0115_36-38_Zafiropoulus 26.02.15 10:38 Seite 2 CDE0115_36-38_Zafiropoulus 26.02.1510:38 Seite 2

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