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ePaper created 2017-05-10, 16:12:25 | version 1.38.0
aesthetic replacement of premolar CE article | Fig. 4 Fig. 5 A prescription to the lab was provided, ordering a partial denture fabricated from duracetal resin and to develop a tooth born surgical guide. The lab was in- structed to simulate the extraction site by removing the tooth from the study cast provided. This model was duplicated for fabrication of the two appliances. site. The partial was delivered uneventfully. These appliances are extremely retentive and not subject to dislodgement or pressure over the implant site dur- ing function. The patient was seen one week later for a postoperative check and adjustment of the tempo- rary appliance (Fig. 4). Fig. 4: Temporary DuraTek partial. Fig. 5: Healed implant site with healing abutment. The laboratory product was provided to the sur- geon. Atraumatic extraction was accomplished and an immediate implant (Legacy 3, Implant Direct) was placed with facial bone grafting (Figs. 2 & 3). The patient was instructed to return to the surgical clinic in approximately four months for final evalua- tion prior to restorative procedures. There was a healing screw placed and the site was closed with appropriate membrane and suturing techniques. The unilateral partial was not delivered at time of surgery. The patient was seen in the restor- ative office, and the partial (DuraTek, Drake Precision Dental Laboratories) was modified to provide tissue support and begin development of an ovate tissue Four months after surgery, the patient was seen by the surgeon to uncover the implant, remove the healing screw and place a temporary abutment. The temporary partial was adjusted to accommodate the added height of the healing abutment (Fig. 5). The patient was instructed to return to the restorative office for definitive restoration of the implant in approximately three weeks. Fig. 6 Fig. 7 Fig. 8 Fig. 6: Well healed mucosa. Fig. 7: Placement of impression coping. Fig. 8: Final PVS impression. Fig. 9: Crown and abutment on analogue model. Fig. 9 CAD/CAM 2 2017 33