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ePaper created 2017-03-17, 10:24:23 | version 1.38.0
Fig. 9a Figs. 9a–i (a) Occlusal view of the implant in place at the time of the final impression. The center of the implant (yellow circle) corresponds to the incisal edge of the adjacent teeth. (b) A shoulderless zirconia abutment. (c) The final crown on top of the abutment. (d) The ideal placement of the implant will generate the correct cervical contour and EA. (e & f) Frontal and occlusal views of the final zirconia abutment in place. The screw access hole has been filled with PTFE and composite. (g & h) Final lithium disilicate crown cemented, with the final radiographic control. (i) Smile with final restoration. Fig. 9b Fig. 9c Fig. 9d Fig. 9h Fig. 9e Fig. 9f Fig. 9g Fig. 9i Conclusion Whenever a vertical (shoulderless) prepa- ration has been chosen for the definitive implant abutment rather than a horizon- tal (shoulder or chamfer) preparation, changing the buccolingual position of the implant is recommended, especially in the esthetic zone. The long axis of the implant should correspond to the incisal edge of the future restoration or of the adjacent teeth, assuming that 1.5–2.0 mm of the buccal bone can be main- tained. This is the only position that enables fabrication of a restorative crown with a cervical contour resembling, as close as possible, what nature originally provided. It also eliminates problems with cement removal, greatly reducing the incidence of iatrogenic periimplan- titis and making hygienic procedures much easier. Scientific data substantiat- ing these observations are lacking. There- fore, randomized and prospective clini- cal trials are necessary. Editorial note: A list of references is available from the publisher. 62 — issue 2017 Advanced Implant Esthetics Article