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Dental Tribune Middle East & Africa Edition No. 5, 2015

30 Dental Tribune Middle East & Africa Edition | September-October 2015implant tribune < Page 28 Fig. 11 Fig. 16 Fig. 21 Fig. 12 Fig. 17 Fig. 22 Fig. 13 Fig. 18 Fig. 23 Fig. 14 Fig. 19 Fig. 15 Fig. 20 in regenerated bone, immediate restoration was not attempted. No additional grafting material was needed. (Fig. 12, 13) 3. After 4 months exposure was carried out using a punch gingi- vectomy approach. 4. A temporary cylinder was seated and a clear crown form was used with cold cure acrylic to fabricate a temporary crown. This was Torqued to 20N/ cm and cotton wool and Cavit placed in the access hole. (Fig. 14, 15) 5. 4 Weeks healing was allowed for gingival contour to be devel- oped (a little longer would have been preferred however the pa- tient was moving away from the region) (Fig. 16) 6. Pick up coping impression was taken with Impregum injec- tion into sulcus to capture emer- gence profile developed with the temporary crown. Occlusal re- cords and shade were taken and agreement was reached with the patient on a midline diastema to improve symmetry. (Fig. 17) 7. The porcelain fused to metal, screw retained crown was tried in, and the fit and occlusion were checked then, after aes- thetics had been approved by the patient, a square Goldtite screw was torqued to 32 N/cm and access sealed with cotton wool + composite (Figs 18, 19) 8. A final x-ray was taken and oral hygiene instruction and re- call advice were given. 9. The patient returned one year later for a recall examination and x-ray and was still delighted with the aesthetic improvement (Fig. 20, 21, 22) This case report illustrates the fact that not all tooth replace- ment problems can be managed by immediate or rapid implant restoration of the lost teeth. While the concepts of immedi- ate replacement and immediate loading of implant prostheses certainly has a place in our ar- mamentarium, it is not applica- ble to all situations and is cer- tainly a long way from being a panacea. We may all enjoy fast food occasionally, but generally slower, more relaxed fine dining is preferred. It is perhaps appro- priate to consider Dennis Tar- now’s maxim “Do one miracle at a time”. Crawford Bain BDS, DDS, MSc, MBA Professor of Periodontics and Programme Director of Gradu- ate Periodontics Hamdan Bin Mohammed College of Dental Medicine, Dubai, UAE About the Author • NuOss® is physically and chemically comparable to the mineral matrix of human bone • NuOss® is one of the most reliable bone substitutes used by dental professionals • Natural anorganic bovine bone matrix; available in 6 different forms to best suit your surgical needs YOUR GENERATION OF BONE REGENERATION. NuOss® is a registered trademark of ACE Surgical Supply Company, Inc. Copyright © 2015. NuOss® is manufactured for ACE Surgical Supply. Contact Your Local ACE Surgical Dealer. cancellous and cortical granules collagen blockparticulate in a delivery syringe expanding composite TODAY’S DENTAL PROFESSIONALS RELY ON NUOSS ANORGANIC BOVINE BONE.

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