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ePaper created 2016-01-26, 19:35:58 | version 1.38.0
case study _ implant treatment I supported. Following placement of the implant-specific Healing Abutment Uni (DENTSPLY Implants), the soft tis- sue was sutured (Figs. 5 & 6). The patient was recommended soft and liquid foods and to avoid chewing on the implant. After approximately 4 months, the peri-implant mucosa had healed without complications. During the healing phase, the defects of tooth 45 were aesthetically corrected with dental composite in order to facilitate the future provision of a crown (Figs. 7a–c). For the purposes of this case presentation, re-entry was carried out to inspect the marginal bone. Even without an augmentation of the dehiscence defect, bone regeneration had developed to the level of the buccal implant neck. After the re-entry procedure, theHealingAbutmentUniwasre-inserted,andthe soft tissue was sutured (Figs. 8a & b). Fabricationofthecrown Two weeks later, the process of fabricating the implant restoration began (Figs. 9a & b). When using the OsseoSpeed TX Profile implant, specific prosthetic components must be used. The use of a titaniumabutmentisrecommendedintheposterior region with heavy occlusal load and little aesthetic requirements. It provides stability, while having no limiting effects aesthetically. For best results, the prefabricated TiDesign Profile titanium abutment was individualised in the laboratory to optimise the emergence profile and the progression of the marginalgingiva.Whencementingporcelain-fused metal crown (PFM), care was taken to ensure that all cement residues were thoroughly removed (Figs. 10–12). Follow-up Clinical and radiological images were taken one, two and three years after implant placement and demonstrated the good clinical results of using the OsseoSpeed TX Profile implant. The interdependent features of the ASTRA TECH Implant System Bio- Management Complex together with the sloped implant neck worked to preserve the peri-implant tissues. No bone remodelling was observed, with the buccal and interproximal bone levels remaining stableattheleveloftheimplantshoulder.3 Further- more, the mesial and distal interdental papillae regenerated,andaninflammation-free,keratinised peri-implantmucosadevelopedaroundtheimplant crown (Figs. 13–15c). _Discussion The criterion for successful implant therapy is the preservation of the peri-implant bone-level. It is of significant prognostic importance. _Conclusion TheOsseoSpeedTXProfileimplant,canenablefav- ourable aesthetic and functional results, not only in the aesthetic zone but also in the atrophied alveolar ridge and even without augmentation procedures._ Fig. 12_X-ray after cementation of the crown confirmed the absence of any excess cement. Fig. 13_After one year, width of the gingiva and regeneration of the papillae were evident. Figs. 14a–b_Clinical and radiological situation two years after implantation with optimal hard and soft tissue structures. Figs. 15a–c_After 3 years, an increase in width of the peri-implant mucosa was observed, along with preservation of the bone up to the level of the sloped implant shoulder. Editorialnote: Acompletelistofreferences isavailablefromthepublisher. I 11 cone beam 1_2016 Dr Robert Nölken,MSc Private practice in Lindau and University of Mainz, Germany cone beam _contact Fig. 15c Fig. 15b Fig. 15a Fig. 14b Fig. 14a CBE0116_08-11_Noelken 21.01.16 11:00 Seite 4 CBE0116_08-11_Noelken 21.01.1611:00 Seite 4