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14 I I clinical article_ treatment planning inserted subcrestally with a final insertion torque of 50 Ncm (Figs. 9b, 9c). The crestal gaps between the implant and osteotomy were augmented with feline periomix, a DFDBA product (Veterinary Transplant Service, Kent, Wa.), which was rehy- drated with 2 percent Xylocaine with 1:50.000 epinephrine (Dentsply, York, Pa.). Flap apposition was made to achieve primary closure with a com- bination of simple interrupted and cruciate suture patterns. Suture material was 5-0 Securocryl with areversecuttingP3needle(SecurosSurgical,Fisk- dale, Mass.) (Fig. 9d). Recovery was uneventful, and the patient was dischargedwithpostsurgicalinstructionsthesame day. Clavimox (62.5 mg/ml for 1 ml bid) (Zoetis) and Buprenorphine (0.1ml bid orally for 3-5 days) (Reckitt Benckiser Health Care) were dispensed. _Uncovering and restoration phase At five-months post-implant placement, the patient returned for the start of the restorative phase (Fig 10a). FAP was administered and radio- graphswereobtainedtoverifyosseousintegration (Fig. 11). A tissue punch was utilized to expose the cover screw, and it was removed from the implant (Figs.10b,10c).Itiscrucialtodevelopandmaintain healthy keratinized tissue at the healing abutment site. This KT will minimize bone resorption and inflammatory reaction around the prosthetics.6, 7 A closed tray impression coping was secured to the implant (Fig. 12, bottom), and VPS impres- sions were obtained. The impression coping was removed intraorally, and a healing abutment was placed (OCO Biomedical) to develop the tissue emergence profile (Fig. 12, top). Theimpressionsweresenttothedentallab(Pre- cisionCeramics,Montclair,Calif.),andasoft-tissue stone model was created with the implant analogs within the model. The final restoration would be a custom anodized abutment and solid zirconia crown to be luted to the abutment. The soft-tissue modelwasdigitallyscannedanddesignedvirtually (Fig. 13). The abutment was CAD/CAM milled, and then the zirconia crown was milled to fit the abut- ment (Fig. 14). Onemonthpost-impressions,thepatientagain returned for delivery of the final components. Patient was anesthetized with the same protocol utilized at the prior appointments. Radiographs were obtained to verify the proper seating of the abutment into the implant (Fig. 15). After verifica- tion, the abutment screw was hand tightened and checked with the torque wrench for the manufac- turer recommended 30 Ncm. The zirconia crown was cemented to the abutment utilizing BisCem (Bisco Inc.), and the prosthetics were complete. The patient was seen for several post-operative appointments. At 7- and 10-month visits, pho- tos demonstrate exceptional results with this paradigm shift in the treatment of non-repairable fracturedmaxillarycuspidsinthiscat(Figs.16,17). _Conclusion Replacementoflostcaninesinfelinesallowsthe animals to maintain a better diet by helping them to better masticate food. This allows the animals to gain proper nutrients from food, which helps maximize overall health and lifespan. Addition- ally, as the animals are able to chew normally, the authors believe they have a better psychological well-being,leadingtoahappieranimalandoverall better quality, and ultimately, quantity of life. Digitaltreatmentplanninghasmadeadramatic changeinthewaydentalimplantscanbeincorpo- rated into our canine and our feline patients. This provideseasiertreatmentbythepractitioneryield- ing a superior product as compared to traditional methods previously utilized as discussed in Case 1. As with human patients, treatment options need to be provided with the animal’s owner making thefinal,informeddecisiononcaretoberendered. Referencesareavailableuponrequestfromthe publisher._ implants 1_2016 Dr. Rocco E. Mele has been practic- ing veterinary medicine and surgery for more than 40 years through- out the United States. He attended Youngstown State University, Ohio State, before an early acceptance to the Ohio State School of Veterinary Medicine, graduating in 1973. With the help of veterinary dental special- ists, human-patient dentists and oral maxillofacial surgeons in the United States, Canada and Australia, he has been placing implants and using the most advanced augmentation techniques and bio-materials for the past 10 years. Dr. Anthony Caiafa has both a bach- elordegreeinveterinaryscience(Uni- versityofMelbourne,1978)andden- tal science (University of Melbourne, 1998). He is a lecturer in veterinary dentistry at James Cook University, veterinary dental consultant for North Coast Veterinary Specialists, Tan- awha, Queensland, Australia, and a member (by examination) of the Australian and New Zealand College of Veterinary Scientists in small ani- mal surgery and veterinary dentistry. He is an adjunct associate professor veterinary sciences and biomedicine faculty at James Cook University in Townsville, Queensland, Australia. Dr. Gregori M. Kurtzman is in private generalpracticeinSilverSpring,Md., and is a former assistant clinical pro- fessor at University of Maryland and a former AAID implant maxi-course assistant program director at Howard UniversityCollegeofDentistry.Hehas lectured internationally on the topics of restorative dentistry, endodontics, implant surgery, removable and fixed prosthetics and periodontics and has published more than 490 articles. _about the authors Fig. 15 Fig. 16 Fig. 17 Fig. 15_Radiographs at abutment placement. Fig. 16_Completed restoration seven months post-insertion demonstrating a lack of soft- tissue inflammation. Fig. 17_Completed restoration 10 months post-insertion demonstrating a lack of soft- tissue inflammation.