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ePaper created 2015-09-09, 12:07:54 | version 1.38.0
I review _ implant abutment and gold titanium abutments for screw retained bridges. Abutment selection in posterior sites Clinical indication of each implant abutment type depends primarily on the prosthetic position oftheimplantandwhethersingleormultipleunits need to be replaced. Standard and Straumann Variobase abutments are the abutment of choice in posterior sites if the prosthetic position of the implant is ideal. Angled standard abutments, in- dividualised CAD/CAM abutments made of tita- nium, or cast abutments in gold are indicated in cases where the implant is not placed in an ideal prosthetic position. In multi-unit reconstruc- tions, standard titanium or individualised gold abutments are recommended. _Case report Restoration of a single edentulous gap with an all-ceramic screw-retained implant crown in a posterior site using the Straumann Variobase Abutment. A 43-year-old, non-smoking, healthy female patientwithasingleedentuloustoothgap,region 46 came for treatment. A Straumann Soft Tissue Level Regular Neck Implant with Straumann SLActive surface was placed in a correct three- dimensional position (Fig. 3). Open-tray impres- sion and bite registration followed eight weeks later. Peri-apical radiograph for evaluation of the impression coping position (Fig. 4). Fabrication and articulation of the master casts. Insertion of the scan body. The cast was centralised in the scanning machine (Fig. 5). Bite registration with the scan body in place (Fig. 6). Verification of digital image and manual modification, matching occlusion of the oppos- ing dentition (Figs. 7 & 8). A Straumann Variobase Abutment was used (Fig. 9). An IPS e.max CAD crown made of lithium disilicate glass ceramic was ordered and delivered to the dental labora- tory in a bluish colour (Fig. 10). The crown was cut back with a diamond bur and crystallised in a furnace. Characterisation and finalisation of the crown followed by the manual addition of veneering ce- ramic (IPS e.max. Ceram) and the use of stain and glaze paste (IPS e.max Ceram Essences and FLUO). Different firing cycles. Cementation of the crown ontheStraumannVariobaseAbutmentwithadhe- sivecement(MultilinkHybridAbutmentCement). The excess cement was removed and polished (Figs. 11 & 12). The final crown was tried intra- orally and inserted with 35 Ncm inside the implant (Figs. 13 & 14). Evaluation of the crown position (Fig. 15). The occlusion was adjusted and oral hygiene instructions given to the patient._ IPS e.max CAD, IPS e.max. Ceram, Essences and FLUO are registered trademarks of Ivoclar Vivadent, Schaan, Liechtenstein. Editorial note: A complete list of references is available from the publisher. 16 I CAD/CAM 3_2015 Dr Julia-Gabriela Wittneben DMD,DR MED DENT,MMSC SWITZERLAND Senior Lecturer at the Department for Reconstructive Dentistry and Gerodontology,School of Dental Medicine,University of Bern,Bern,Switzerland. Lecturer at the Department of Restorative Dentistry and Biomaterials Sciences,Harvard School of Dental Medicine,Boston,USA.DrWittneben can be contacted at julia.wittneben@zmk.unibe.ch. The case presented in the article was treated in a multidisciplinary approach: _Prof.Dr med dent Daniel Buser (Surgical) _Dr med dent Julia-GabrielaWittneben, MMSc (Prosthetics) _Thomas Furter,CDT (Lab) CAD/CAM_about the author Fig. 15