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ePaper created 2017-03-17, 10:24:23 | version 1.38.0
ABOUT THE STEIGMANN INSTITUTE COURSES Dr. Marius Steigmann, Germany the prosthetic reconstruction. Single- implant placement has proved to be more predictable than multiple-implant place- ment. In the case of multiple implants and delayed loading, it is possible to form a soft-tissue profile with provisionals or proceed directly to the final reconstruc- tion. This is done with the help of a wax-up on the final metal frame to control the pressure of the soft-tissue intraorally. Clinically, it is a tremendous challenge to create natural gingival esthetics after immediate or delayed implant placement. Stability of the soft tissue during implant surgery is of major importance for the implant site and adjacent teeth. For cases in which only the tooth is compromised and not the soft-tissue or osseous form, a flapless surgery can be performed. In cases of localized horizontal or vertical deficiency, dehiscence or fenestration, another approach is necessary. From a prosthetic prospective, the soft-tissue architecture around implants has to be similar or close to that of the natural tooth. While the dental laboratory can deliver the best functional and esthetic work, it will be harmonious only if the soft-tissue dimensions are maintained or developed surgically or with the help of 68 — issue 2017 Advanced Implant Esthetics Article