Maxillary central incisors implant technique using CAD/CAM customized abutments.

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
Clinical findings

  • Crown fracture of maxillary anterior teeth
  • Root fracture of Lt. central incisor
  • Apical radiolucency and fistula
teeth fracture 


  • #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.
Teeth extraction and implant placementFig. 1 Extraction and curettage 
Fig. 2 Implant placement
Syhnthetic bone and temporary restorationFig. 3 Gap filling with syhnthetic bone 
Fig. 4 Temporary restoration

Provisional Restoration
A provisional restoration supported by a temporary abutment was placed 10 weeks after implant placement.

Temporary abutment and restorationFig. 5 Temporary abutment
Fig. 6 Provisional restoration

CAD/CAM Abutment
A SmartFit abutment was fabricated with a fixture-level impression and a cast.

Abutment connection and a new provisional Abutment connection and a new provisional Abutment connection                                             A new provisional

Final Restoration
A metal-ceramic restoration was fabricated on a stone cast taken directly using silicone rubber impression material.

Final restoration


Customized CAD/CAM abutment system (Osstem SmartFit Abutment) is a promising technique to overcome many shortcomings of conventional readymade abutments or manual milling abutments.


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