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CAD/CAM - international magazine of digital dentistry

| case report aesthetic restorations 20 CAD/CAM 2 2016 Fixed aesthetic restorations Combining implantology with dental CAD/CAM technology Authors: Dr Dario Žujic, DT Velimir Žujic, Croatia & DT Dragan Stolica, Slovenia Full-archimplant-supportedsuperstructurescan be achieved by various methods. Depending on the bone quality and number of implants, the patient may either receive a fixed or removable implant restoration. If a fixed prosthesis is indicated, the superstructure may either be cemented or, alternatively, screwed directly to the implant fixture, depending on the clinical situation. In the case described here, we opted for a ce- mented zirconium oxide bridge.Monolithiccrowns were used in the posterior region. For the anterior region, the crowns were cut back and veneered. Translucent zirconium oxide (Zenostar T, Wieland Dental) was used for the framework and IPS e.max Ceramfortheveneeringoftheanteriors.Thesema- terials allowed us to achieve the desired strength and aesthetics. When the patient came to our dental lab, she wore a classic full-arch denture in her upper jaw. She was unhappy about the aesthetic appearance, functional qualities and the loose fit of the denture. Heroralconditionwasassessedwithdigitalvolume tomography (DVT) to confirm that adequate bone quantitywasavailabletofacilitatetheanchorageof the implants. Although the placement of four implants would have provided adequate stability for a removable denture, the patient asked for a fixed all-ceramic reconstruction. Having discussed the treatment options with her, we abandoned the idea of provid- ing an implant-supported denture based on the “All-on-4” concept and instead chose to manufac- ture a fixed, implant-retained bridge. The frame- work would be made of zirconium oxide and the anterior teeth would be individually veneered. Based on the DVT examination, seven implants (Replace CC, Nobel Biocare) were planned and placed. An adequate primary stability of 30 to 35 Ncm was achieved. During the healing phase, Fig. 1: The seven implants in the edentulous jaw were to be connected to a fixed bridge made of zirconium oxide. Figs. 2a & b: Digitized model with temporary restorations (above) and abutments (below). Fig. 1 Fig. 2a Fig. 2b 22016

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