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17Implant TribuneMay 2014United Kingdom Edition C M Y CM MY CY CMY K DentalTribune_CO_A4_June13.pdf 1 17/06/2013 20:03:40 page 18DTà Fabrication of a customised implant abutment using CAD/CAM: A solution specific to each clinical case Dr Thierry Lachker describes an implant case T he multiplicity and so- phistication of the offer- ing in the field of pros- thetic elements in implantology allow the practitioner to make a choice appropriate to the clini- cal particularities of each case. If the practitioner chooses a stand- ard implant abutment, the den- tal technician will have to make adjustments, which implies con- siderable losses in precision and time. Moreover, with such abut- ments it is difficult to create an anatomical emergence profile because it cannot be modified and the base of the abutment cannot be changed. This ob- servation is equally applicable to the angulation, which might even be selected by default. A customised abutment cre- ated with CAD/CAM is the most accurate and simplest solution for an optimal result. The abut- ment is individually designed in order to ensure the homothety of thethicknessofthematerialsand therefore the overall strength of the prosthesis. The dental tech- nician has in this case maximum freedom in terms of design in or- der to create an abutment with the optimum emergence profile and angulation. In this manner, the abutment is specifically de- signed and fabricated for each patient. Titanium has been estab- lished in dental implantology as the reference material owing to its biomechanical properties and its biocompatibility. Today, we are able to benefit from over 40 years of clinical and experimen- tal experience in implantology. Customised abutments can be fabricated from titanium, zirco- nia or hybrid materials, such as a combination of titanium and zirconia, which in certain clini- cal circumstances improves the aesthetics of the visible areas while respecting the require- ments of biocompatibility and biomechanics. Seating a four-unit bridge on three anatomical implant abutments Clinical case A 40-year-old male patient pre- sented for treatment. He had no particular medical conditions or any contra-indications concern- ing the placement of implants. In 2009, the patient had undergone a sinus lift (an increase of the maxillary bone volume and the displacement of the sinus mem- brane to ensure implant success by increasing the height of the available bone) at a hospital pri- or to the placement of implants to replace teeth 15–17. The post- operative sequelae (pain, oede- ‘A customised abut- ment created with CAD/CAM is the most accurate and simplest solu- tion for an optimal result’ DentalTribune_CO_A4_June13.pdf 117/06/201320:03:40