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CAD/CAM - international magazine of digital dentistry

The intact surrounding support structure of the adjacent teeth helps in the realisation of a naturally shaped papilla. The zirconium dioxide crown was ce- mentedwithDurelon,thecementresiduewascarefully removed, and the patient left the dental practice with a permanent aesthetic prosthesis (Fig. 31). Twelve months after insertion, the patient presented in our practice for a follow-up. The images show a stable periimplant hard and soft tissue situation (Fig. 32). The migration of the gingiva had led to considerably more natural shaping of the interdental papillae, and the gaps had virtually closed. The aesthetic outcome of the 3-D implant insertion in combination with the intactapproximalboneleveloftheadjacentteeth and adequate height and width of the periimplant hard and soft tissue was again confirmed at the 24-month follow-up(Fig.33). _Discussion The prospective implant status demonstrated in- sufficient alveolar ridge tissue. Aesthetic implant restoration was therefore only possible with bone and soft tissue augmentation. As a single-step surgical procedure did not allow for a prosthetically correct placement of the implant, a two-step procedure was indicated. Perfect red-white aesthetics place great demandsontheperiimplanthardandsofttissue. _Conclusion Intheaestheticallydemandinganteriorregion,im- planttherapyrepresentsbothavaluableandchalleng- ing alternative for replacing lost teeth. The surgical treatment plan based on the patient's wishes, pros- theticanalysisandawax-up,shouldbecompiledonthe basisoftheexistinghardandsofttissue.Theindividual treatment steps, as well as treatment times and costs shouldbediscussedindepthwiththepatient._ Editorial note: A list of references is available from the publisher. I case report _ implant restorations 30 I CAD/CAM 3_2015 Fig. 27_The abutment was created with the 3Shape® abutment designer. Fig. 28_The customised zirconium oxide abutment was bonded to the titanium bonding base and the zirconium crown was veneered individually. Fig. 29_The individual hybrid abutment shapes the desired emergence profile. The gingiva is revascularised after approximately three minutes. Fig. 30_Immediately after insertion, the crown appears to be somewhat too long in the cervical region and the papillae are not shaped optimally. Fig. 31_The patient displayed an aesthetic lip appearance. The position, colour and shape of the restoration blend in harmoniously with the dental arch. Fig. 32_At the follow-up, good reconstruction of the oro-vestibular dimension is observed. Fig. 33_At the follow-up after two years, the interdental papillae were fully shaped and the gaps closed. Fig. 30 Fig. 32Fig. 31 Fig. 27 Fig. 29Fig. 28 Fig. 33 Dr Jan Spieckermann Joint practice for oral surgery Specialists for oral surgery, Focus on implantology An der Markthalle 3 09111 Chemnitz,Germany info@oralchirurgie-chemnitz.de Jörg Wildenhain Kauzentrum Dentallabor Chemnitz Dental laboratory Gießerstr.13 09130 Chemnitz,Germany CAD/CAM_contact

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