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ePaper created 2017-11-09, 09:28:26 | version 1.38.0
industry | Fig. 3 Fig. 4 Fig. 1 Fig. 1: XXX Fig. 2: XXX Fig. 2 Fig. 5 Fig. 1: DICOMs were imported into the implant planning software (coDiagnostiX™). Fig. 2: Scan files were imported into the laboratory software (Straumann® CARES® Visual). Fig. 3: The surgical guide was sent to a lab to be printed by an Objet30 OrthoDesk (Stratasys). Fig. 4: The provisional file was sent to Straumann Milling Center in Arlington to be fabricated out of polycon ae (PMMA). Fig. 5: Straumann® PURE Ceramic Implant design is a combination of the tissue level and bone level implant. which has a unique driver, to ensure proper placement of the implant. However, the Straumann® PURE Ceramic Implant currently does not have such a driver, therefore, the surgical guide was only used to prepare the oste- otomy while implant placement was performed free- hand. Bone quality was determined to be Type II. The Straumann® PURE Ceramic Implant comes with a sepa- rate transfer piece for placement which snaps into place much like the Tissue Level impression cap. Three dots on the driver line up with a flat surface of the abutment portion of the implant and also indicate distance to the shoulder (1, 2 and 3 mm). The implant was placed with- out any incidence to the desired depth and position of the dots (Figs. 7–9). During the healing phase, a protective cap is placed over the abutment to protect it. Since the patient was concerned with aesthetics and has a high smile line, it was decided to place a provisional to provide more aes- thetic appearance. The recommendation by Straumann not to immediately load a PURE implant was taken into account during the DWOS Synergy™ design session by eliminating occlusal and lateral contacts. This provisional was then further modified at time of surgery by further reducing the anatomy and creating more of a custom healing abutment than immediate provisional. The pro- visional was cemented using temporary cement (Temp- Bond, Kerr) and only two interrupted sutures were re- quired to secure the flap. At the one-week follow up, the tissue was healing beautifully around the implant and the patient was scheduled for the final impression seven weeks out (Fig. 10). Final result The patient was in slight discomfort following the sur- gery, but stated that this surgery was less painful than the previous extraction. She was pleased to have the modi- fied provisional versus a dark space in her smile. Conclusion Since the Straumann® PURE Ceramic Implant end- osteal portion is based on the Straumann® Bone Level implants 1 2017 23