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ePaper created 2016-06-01, 09:58:05 | version 1.38.0
20 I I industry_ Glidewell Laboratories implants 1_2016 _Withmorepatientsseekingdentalimplanttreat- ment, it’s no surprise that a growing number of clini- ciansareprovidingthisservice.Theincreaseddemand forimplanttherapycanbeattributedinparttotheim- provedpredictabilitybroughtaboutbyinnovationsin implantdesign.Additionally,duetoadvancementsin all-ceramic restorative materials, providing esthetic resultsiseasierthaneverbefore.Byutilizingthemost advanced implants and restorative materials, even experienced implantologists have the potential to benefitfromanimprovedclinicalworkflowandmore esthetic results. The case report that follows demonstrates im- mediate tooth extraction and placement of a Hahn TaperedImplant(GlidewellDirect;Irvine,Calif.)inthe area of a lateral incisor. A temporary bridge, custom implant abutment and a highly esthetic final crown are utilized to facilitate a natural-looking final res- toration. _Case report A 40-year-old male presented with no medical complicationsanddesiredanicesmileforhisbusiness interactions.Hismaxillaryleftlateralincisorhadfrac- tured,withthepatient’sexcessiveparafunctionlikely a contributing factor. Endodontic evaluation had determined that the lateral incisor was untreatable. The patient accepted a treatment plan in which the lateral incisor would be extracted and an implant im- mediately placed. Designed to achieve the maximum primary stability needed for immediate extraction and implantation cases, a Hahn Tapered Implant was selected for the procedure. To begin treatment, the non-restorable lateral incisor was extracted atraumatically. Removing the tooth in this manner maintained the facial plate of bone as well as the interseptal bone that helps sup- port the interdental papillae. A pilot drill was utilized to create the initial osteotomy approximately 3 mm apical to the adjacent cementoenamel junction, and a 3.5-mm-diameter Replace Select™ drill (Nobel Biocare, Yorba Linda, Calif.) was used to complete preparation of the implant site. Note that the Hahn TaperedImplantiscompatiblewithwidelyusedsurgi- cal instrumentation. As the implant was threaded into place, its promi- nentbuttressthreadsengagedthepalatalwallfirmly. Thissimplifiedtheeffortofpreservingthefacialplate and positioning the implant in a manner that would foster an esthetic outcome. The tapered body of the implanteasedplacementwithinamaximumamount of bone, and its widened apex helped establish excel- lent stability. Radiography confirmed the implant was placed in an optimal position. A transitional bridge was fab- ricated to minimize speech problems, help support the soft tissue and maintain a natural emergence profile during the healing period. After four months ofhealing,thetemporarybridgewasremovedandan open-tray final impression was taken. An Inclusive® Zirconia Custom Abutment with ti- taniumbasewasproducedbythelabandmaintained a natural emergence profile upon delivery. BruxZir® Anterior, a monolithic zirconia material specially formulated for the smile zone, was chosen for the final restoration because of its strength and lifelike esthetics. The crown, which was digitally designed and milled using CAD/CAM technology, exhibited a precise fit. Final radiography illustrated superb bone preservation at the implant site (Fig. 1). Optimal soft- tissue contours were particularly evident around the beveled edge of the Hahn Tapered Implant. The patient was very pleased with the final restoration (Fig. 2). _Conclusion The high primary stability, optimal positioning and simplified surgical protocol facilitated by the Hahn Tapered Implant make it ideal for a wide range of indications, including immediate extraction cases and restorations in the smile zone. When combined with BruxZir Anterior and zirconia hybrid custom abutments,apredictablerestorationcanbedelivered thatmimicstheestheticsofthetoothbeingreplaced. See more of this case by visiting www. inclusivemagazine.com._ Immediate tooth replacement with the Hahn Tapered Implant and BruxZir Anterior Solid Zirconia Author_Timothy F. Kosinski, DDS, MAGD Fig. 1_Postoperative periapical radiograph illustrates excellent integration of the Hahn Tapered Implant (right) with the surrounding bone in the area of tooth #10. (Photos/Provided by Glidewell Laboratories) Fig. 2_The final restoration of tooth #10 exhibited translucency, color and emergence profile similar to natural dentition. Fig. 1 Fig. 2