An Implant-Supported Restoration of a Maxillary Central Incisor Using a Temporary Abutment and a Customized CAD/CAM Titanium Abutment
By: Hwee-Woong Park
Maxillary central incisors play a critical role in esthetics. One of the most difficult factors for an esthetic implant restoration is the natural profile of the cervical area in which the tooth emerges from inside the gingiva. Many procedures including bone augmentation and soft tissue graft have been suggested to solve this problem. More recently, techniques using CAD/CAM customized abutments are drawing attentions as promising solutions. The author describes a clinical case with a missing upper central tooth restored using an Osstem TS Implant and a customized CAD/CAM (Osstem SmartFit) abutment.
Study Design (Case Report):
Patient age / sex : 28Y / male
C / C: Teeth fracture due to trauma
- Crown fracture of maxillary anterior teeth
- Root fracture of Lt. central incisor
- Apical radiolucency and fistula
- #21 tooth was extracted with minimal trauma and the granulation tissue was removed.
- After careful drilling, a TSIII SA implant (4.0X13mm) was installed.
- Insertion torque was 25Ncm.
- The gap between the implant and the labial alveolar plate was filled with synthetic bone graft material (biphasic calcium phosphate).
- A short healing abutment was connected and a bonded temporary restoration was placed.
Fig. 1 Extraction and curettage Fig. 2 Implant placement
Fig. 3 Gap filling with syhnthetic bone Fig. 4 Temporary restoration
A provisional restoration supported by a temporary abutment was placed 10 weeks after implant placement.
Fig. 5 Temporary abutment Fig. 6 Provisional restoration
A SmartFit abutment was fabricated with a fixture-level impression and a cast.
Abutment connection A new provisional
A metal-ceramic restoration was fabricated on a stone cast taken directly using silicone rubber impression material.
Customized CAD/CAM abutment system (Osstem SmartFit Abutment) is a promising technique to overcome many shortcomings of conventional readymade abutments or manual milling abutments.