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ePaper created 2016-11-23, 14:26:06 | version 1.38.0
industry | 27 4 2016 implants Shealsofoundthatherjawincreasinglyhad a ‘dent’ at that location (Fig. 13). The X-ray taken at intake showed significant conver- gence of the radices of 21 and 23. The inter- dental space was 7.4mm but only 5.2mm apical (Fig. 14). I approached this challenge witha2.8mmimplant.Iimmediatelytookan impressiontomakeatemporarycrownlater. Procedure After I had removed the bonded bridge, Imadeacrestalsulcularincision,afterwhich Itriedtoremoveaslittlemucosaaspossible. Again, I started by making a guide with the osteotome (Netwig) which allowed me to determine the position and direction. By al- waysusingaslightlylargercondenser,Ivery carefully pressed the labial wall down. As there was no large alveolus (no extraction had been done), applying autologous bone using the Dentak K-system was not neces- sary, and I only needed to use the conden- sation technique. Again, the preparation wasmadetothecorrectlengthusingthe2.6 drill. I made a direct temporary crown on a PEEK abutment and paid much attention in thecervicalareatocreatingtheshapeanda proper emergence profile. In this case, an additional complication was that I had to convince the patient of the robustness and reliability of the temporary crown because ofhersix-monthsstayinAfricaimmediately after insertion of the temporary crown on the implant. I was able to give her my expe- riencethatIgainedfromsevenimplantsus- ing this method as an assurance. After six months, she returned to the practice and said that she had not experi- enced any problems. I observed a good ad- aptation of the mucosa (Fig. 15). After re- moving the temporary crown, I made a pop-in impression coping (Fig. 16), which also showed an excellent emergence profile withhealthymucosa.Thelabagainprovided thestructurewiththeseparatecrown.How- ever, in this case, I decided to insert the crownasawholeafterhavingfitteditsatis- factorily and bonded it outside the mouth. This allowed me to avoid any embedding of cement residues (Fig. 17). However, I did ex- ercise some restraint because I now had to tap the Safe-Lock directly on the zirconium dioxideporcelaincrowntofixtheabutment. A special attachment is available for this, which allowed fixing to take place without a problem (Fig. 18). For this patient, I paid mucht attention to the cervical gingival line. The 12 was a cone tooththatwasconstructedwithcomposite, and that was too small. I corrected the pa- tient’s cervical gingival line satisfactorily with an electrotome and reconstructed element 12 with composite. This achieved a good result (Figs. 19–20a). Fig. 16 Fig. 17 Fig. 16: Insertion of a pop-in impression after removal of the temporary crown. – Fig. 17: Bonding of the perma- nent crown. – Fig. 18 Safe Lock with tips. Fig. 18 Friedrich-List-Str. 27 35398 Giessen, Germany +49 (0) 641 6868 1123 www.bioimplon.de patented bovine bone graft composite each granule is a composite of 30% Atelo-Collagen Type I and 70% hydroxyapatite atelopeptidized bacteriostatic properties lyophilized conductive and inductive properties haemostatic properties excellent handling Hypro-Oss ® AD 42016 +49 (0) 64168681123