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ePaper created 2015-09-09, 12:07:54 | version 1.38.0
I case report _ implant restorations Fig. 1_The X-ray shows progressive horizontal and vertical bone resorption. Fig. 2_The too long gingiva shield contributes to resorption due to the rotational freedom of the flipper. Fig. 3_To avoid further traumatisation of the soft tissue, the flipper shield was shortened. Fig. 4_The occlusal top view shows the horizontal hard and soft tissue deficit in the implant region. _The demands of treatment with implants are high, particularly in the aesthetically relevant areas. In the case of difficult morphological conditions, the individual wishes of patients regarding their natural appearance represent a major challenge for the treat- ment team. A host of materials and techniques for crowns and abutments allow for perfect imitation of the tooth structure. However, aesthetic restoration is only successful if a natural periimplant hard and soft tissue profile can be preserved or reconstructed. The following case study illustrates the complexity of implant treatment for combined horizontal and verti- cal bone resorption after the traumatic loss of the left centralincisor. _Dental history and treatment plan The most predictable, stable long-term aesthetic results are achieved through a synergistic process for diagnosis and therapy involving the various dental specialties. Science-based therapies need to be imple- mented with surgical and prosthetic precision and require the active participation of the patient both duringandaftertreatment.A29-year-oldpatientwas referred to our oral surgery practice with the request forimplanttherapyintheanteriormaxilla.Hehadlost the upper left incisor in an accident some months before. The gap had been treated with a flipper by the referring dentist. The removable restoration strongly affectedthesocialwell-beingoftheyoungman. Examinationshowedadvancedhorizontalandver- ticalboneresorption(Fig.1).Anextendedplasticshield on the flipper was to visually compensating for bone loss(Fig.2).Thisuntowarddesignoftheflipperexerted continuous pressure on the alveolar ridge owing to the rotary freedom around the clamping axis, particu- larlyduringremovalbutalsoduringchewingmotions. Thechallengeofaesthetic implantrestoration Authors_Dr Jan Spieckermann & Jörg Wildenhain, Germany 26 I CAD/CAM 3_2015 Fig. 1 Fig. 2 Fig. 3 Fig. 4