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ePaper created 2017-12-06, 11:14:19 | version 1.38.0
| industry Figs. 18a–c: Radiographs at each stage of the new design. Fig. 19: Final intraoral view of the patient. Fig. 18a Fig. 18b Fig. 18c disadvantage, a practical method preferred by clini- cians is to position the implant a bit deeper at the surgery. However, if the predicted resorption does not take place, this approach makes things difficult in the subsequent prosthetic treatment. The final aesthetic and functional expectation of a clinician is a crown which has natural contours and emergence profile. Custom abutments prepared on prefabricated custom abutment bases are ideal, if the coronoapical position of the implant is correct. Unfortunately, many implant companies do not offer variable gingi- val height options for these custom abutment bases. The above case was such a misprediction of postsurgical resorption amount by the clinician, so that it was impossible to reach an aesthetic and functional emergence profile with the custom Ti- Base. The only way to reach a satisfying result was to perform an additional surgery which would be time wasting, costly and perhaps painful postoper- atively. In order to overcome all disadvantages, the manufacturer thus enlarged its product line with a custom Ti-Base that has increased gingival height. With this news design, the clinician was finally able to reach his goal. Furthermore, the manufacturer included this new product in their catalogue for other clinicians who might face the same problem._ Fig. 19 situation could not be observed at the impression stage as the impression coping design were conical and did not pose any problems. The red-dotted lines in Figure 16 clearly demonstrates why the standard Ti-Base abutment was not able to meet the angle for the required fitting accuracy. At that stage, the only way to manufacture an acceptable restoration was an additional surgery which would re-contour the bone around the coronal portion of the implant. Such an intervention would not only lengthen the treatment time but carry a very high risk of aesthetic failure. In order to avoid such an outcome, the manufacturer designed a new custom Ti-Base abutment to be applied in these situations. The new and old design of both Ti-Base abutments can be seen in Figure 17 side by side. The new design solved the problem for this case and now the product is available for general use. Radio- graphs at each stage of the new design can be seen in Figures 18a to c. The final intraoral view of the pa- tient can be seen in Figure 19. Conclusion contact Immediate implantation following tooth extraction is a popular treatment modality. It does not only shorten the whole treatment time but furthermore reduces the surgical procedure overall. However, it is not always easy to predict the postsurgical amount of resorption in every case. In order to overcome this Prof. Dr M. Kemal Unsal Prosthodontist Gaziosmanpasa Mahallesi Filistin sokak 2/8 06700 Cankaya/Ankara, Turkey mkemalunsal@gmail.com Author details 26 implants 3 2017