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ePaper created 2018-01-31, 10:01:59 | version 1.38.0
research | cations15,16 and has been used in dental implants, pro- visional abutments, implant-supported bars, or clamp material in removable dentures.17, 18 PEEK is biocompati- ble and has a natural tooth-coloured appearance, unlike metal reconstructions. Ceramically reinforced PEEK materials were devel- oped to improve the mechanical properties and the colour of dental restorations. One of these materials is BioHPP (bredent medical, Senden, Germany). In abut- ments, the BioHPP is directly injection-moulded to a ti- tanium base and forms a monolithic hybrid abutment called “elegance” abutment, with a screw seat in tita- nium for long-term stability plus a resilient body made of ceramically reinforced PEEK. To shorten procedures and eliminate intermediate prosthetic steps, digital technologies were developed that allow the intraoral scanning of models and attach- ments with a high degree of precision and reproducibility. Chairside CAD/CAM systems such as CEREC (Sirona) allow direct scanning of the abutments and the realization of immediate crowns. The ceramically reinforced hybrid abutments with a PEEK body and titanium base are eas- ily scannable, yielding restorations of high quality with a good prognosis. Problems caused by removing and re- inserting different prosthetic components—such as loss of soft tissue or early marginal bone loss—are reduced or eliminated. This article demonstrates the reliability of the single-session protocol using digital methods for scan- ning and producing crowns complemented with platform switching and evaluates the peri-implant soft-tissue seal. Material and methods Animal protocol An animal experiment was conducted to evaluate an implant placement protocol with immediate load- ing using PEEK and CEREC and to assess the peri-im- plant soft tissue. Forty-eight blueSKY implants (bredent medical) were placed in healing bone. Thirty-two SKY elegance abutments ( bredent medical) were used in the test group and sixteen titanium abutments in the control group (Fig. 1). A randomization scheme was generated using the website www.randomization.com. The Ethics Com- mittee for Animal Research of the University of Murcia, Spain, approved the study protocol, which followed the guidelines established by Directive 2010/63/EU on the protection of animals used for scientific purposes. Six American Foxhound dogs approximately one year of age, each weighing approximately 13–15 kg, were used in the study. Day 0 (first stage) The animals were pre-anaesthetized and taken to the operating theatre where, at the earliest opportunity, an intravenous catheter was inserted into the cephalic vein and propofol was infused at the rate of 0.4 mg/kg/min as a slow constant-rate infusion. Conventional dental infiltration anaesthesia was administered at the surgi- cal sites. Premolar and molar extractions (P2, P3, P4, M1) were performed in both mandibular quadrants of each dog. Fig. 2a Fig. 2b Fig. 2c Fig. 3a Fig. 3b Figs. 2a–c: Animal study protocol with immediate loading. Figs. 3a & b: Linear measurements (in mm): peri-implant mucosa (PM), buccal bone crest (BC), lingual bone crest (LC), top of the implant shoulder (IS), bone crest (BC), distance from the implant shoulder at buccal bone crest (IS-BC), distance from the implant shoulder at lingual bone crest (IS-LC). CAD/CAM 1 2018 09