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ePaper created 2016-10-04, 09:33:57 | version 1.38.0
| ce article aesthetic replacement of maxillary premolar 20 CAD/CAM 3 2016 Aesthetic replacement of maxillary premolar with immediate implant placement and metal ceramic crown over CAD/CAM abutment Introduction This article describes treatment to solve a common dentalcomplication(lossoftoothduetoverticalroot fracture). Contemporary implant therapy and subse- quent CAD/CAM laboratory procedures provide an elegant solution to this patient’s dental emergency. Treatment was accomplished during a period of ap- proximately six months. Case presentation Thepatientwasahealthy,52-year-oldfemalewithan unremarkablemedicalhistory. Herdentalhistoryand general dental health were excellent. Unfortunately, she suffered a vertical fracture of tooth #5, which necessitated its extraction (Fig. 1). Thetreatmentplanwasforextractionandimmediate implant placement with concurrent bone grafting asrequired.Atemporarypartialdenturewasplanned to provide aesthetic replacement and to support andshapetissueduringthehealingprocess.Thefinal restoration was to be a cemented PFM crown sup- ported by an Atlantis (DENTSPLY Implants) gold hue abutment. Material selection was based on the patient’s cross bite occlusion that transitioned from normal to cross bite across this particular tooth’s occlusal table. Crown and abutment could potentially be subject to occlusal stress due to this transitional relationship. A restoration that provides maximum strength was desirable for long-term stability of the restoration. The patient had a thin biotype and the gold hue abutment provides both strength and a more natural tissue colour.1 The gold colour provides ‘warmth’ of colour in the critical transmucosal region. Titanium abutments provide strength but can telegraph a greying effect on thin tissues. Fig. 1: Fractured tooth. Fig. 2: Immediate implant placement. Fig. 3: Bone grafting and membrane placement. Author: Dr Larry R. Holt, USA CE credit This article qualifies for CE credit. To take the CE quiz, log on to www.dtstudyclub.com. Click on ‘CE articles’ and search for this edition of CAD/CAM. If you are not registered with the site, you will be asked to do so before taking the quiz. Fig. 2 Fig. 3 Fig. 1 32016