Their well-proven zirconia material also helps surgeons and prosthodontists looking for less plaque attachment and enhanced soft tissue healing from the day of surgery. Fig.18: Planning the case step-by-step with coDiagnostiX®. 57-58). Prosthetic Solutions. Bridge ... Implant or Abutment Level. II. After a careful examination of the clinical and radiographic findings, we obtained the following treatment options: a. Following the resin polymerization, the temporary crown was unscrewed (Fig. Even when analyzing in detail, the final restoration could be hardly identified (Fig. The following case report describes the procedures of a complete smile makeover in a young lady with very high expectations. 3: Right lateral view of the patient’s smile. Kim S, Jung UW, Cho KS, Lee JS. Comparing the image related to the initial situation with the planned one, it is clear that the smile has been evidently improved. 55: Printed resin model with ceramic veneer and crown in position. 52: After the milling of the zirconia crown and its ceramic veneering, the crown was fixed on the Variobase® by using composite cement. 57: Isolation of the operating field with dental dam for the cementation of the ceramic veneer: for the long-term success of the procedure it is fundamental to have an absolutely dry area. 50 a & b). 0000237637 00000 n and the loading protocol. 1.    Preliminary data acquisition: intra and extra oral photos, digital impressions (DWOS Virtuo Vivo ™) and CBCT exam. Name * Description. Meanwhile the ceramic veneer for tooth 12 was also prepared and ready to be cemented. Patient solutions. For the cementation of ceramic veeners, it is fundamental to have an absolutely dry area. Fig. 0000002055 00000 n The specific handle reduces the dimension of the sleeve to those of the selected drill. With the use of this assessment, the clinician can follow a step-by-step online procedure by introducing the data related to the patient (e.g. 32: After the guide placement, the milling cutter bur was used with the purpose of creating a flat surface for the precise work of the further drills. 64). 37) and the dedicated BLX® transfer piece drove the implant in the correct position (Fig. 0000000856 00000 n Dentsply Sirona ( previously Astra) Implants. , Straumann® Mini Implants. �Q����N��`�����PpW�4����r �-}_DЅJɎ!ըt���*��� � The overall time of the treatment can be reduced. It started by using the milling cutter bur in order to create a flat surface for the precise work of the further drills (Fig.32), followed by the pilot drill (2.2mm diameter) (Fig. High-performance Zirconia 13 Institut Straumann AG, Straumann® PURE Ceramic Implants A 100 % proof test ensures reliable implant strength. 46). 43). (, 4.    Production of printed surgical guide and resin models via coDiagnostiX® plan (, 5.    Execution of the provisional crown by dental lab on the basis of digital wax-up (on resin printed models) (, The patient underwent local anesthetic infiltration in the area corresponding to the canine apex (, After the extraction, the surgical guide was placed in the patient’s mouth as it is important to verify the stability and the precision of it through the windows created into specific locations (, Following guide placement and verification of the fit, the dedicated set of surgical instruments were ready to use (, As described in the instructions for use, the drilling procedure was carried out until the stop, located on the drill itself. 6.    Guided implant placement with a flapless technique and provisional crown positioning. Fig. 03/14 490.028/en/B/001. Fig. 47). Finally, the screw head was protected by using a teflon floss and then the screw channel was filled with composite (Fig. After the extraction, the surgical guide was placed in the patient’s mouth as it is important to verify the stability and the precision of it through the windows created into specific locations (Fig. A 63-year-old female patient presented with a severe chronic periodontitis at the mandibular arch. 8.    Final rehabilitation with screw-retained crown on BLX implant and ceramic veneering of tooth 12. 9-10). The Straumann PURE Ceramic Implant is based on features of the Straumann PURE Ceramic implant Monotype. systemic conditions, local factors, etc.) The patient can be provided, as requested, with a non-invasive surgical approach allowing the presence of a fixed provisional crown along the whole therapy. This allowed us to pre-visualize the final shape of the tooth and to then remove the correct amount of enamel and create the exact space for the ceramic veneer. 1). Straumann® implant restorations use state-of-the art CADCAM technology. However, it is not only important to perform a careful decision-making process in order to define our clinical approach and workflow, but also to select the proper quality and design of materials for our treatments. As for this, the overall treatment workflow was divided in 8 phases: 1.    Preliminary data acquisition: intra and extra oral photos, digital impressions (DWOS Virtuo Vivo ™) and CBCT exam. %PDF-1.4 %���� Note that the deciduous tooth is shorter than the contralateral, both at the occlusal and at the gingival side. The presence of a favorable site anatomy and a convenient amount of keratinized gingiva will reduce the risk of esthetic complications. 52). Fig. Prosthetic Solutions. The SAC Assessment tool (based on ITI SAC Classification) can be successfully used for this matter. Fig. Fig. - Dr. Michael Sicklick, Teaneck - NJ. The restorative platform of the implant should be above the gingival crest, and the shortest LoCaToR®abutment providing a margin above the gingival crest should be utilized. Fig. Dental implants and Straumann move hand in hand. With the use of this assessment, the clinician can follow a step-by-step online procedure by introducing the data related to the patient (e.g. 35: In accordance with the choice done during coDiagnostiX® planning, a BLX with 4.5 mm diameter and 8 mm length was used. Fig. 0000001345 00000 n The patient and our team were extremely satisfied with the final outcome in terms of health, esthetics and function. 15-17). One system with one kit can be used for all indications and a unique portfolio of different materials and surfaces, including groundbreaking technologies such as Roxolid® and SLActive®. H��W[O\���?�#D���E�,�1vvk��HypV+26рm�q�_�������8M��{}U�뢄A�w�����rz�^���P�)�g�Ϭ���[ܸ��������/�>�>�]�\>�]o���r��?�/6(���%i�'Z�Sm��v&'���fq)⥰�I��&��|�j9�mw������ŗOy��L�/�����%�|�u1��Xe��8���c�8�����y��ZQ��hscA^lo�ӟo�x�yy����5�f�b�[��. Temporary Restoration RB. Fig. 2.    Esthetic analysis of the clinical case, pre-visualization of the final result by using a mock-up. The occlusal view after the implant placement and the removal of the guide showed an optimal 3D implant position (Fig. Fig. Furthermore, the implementation of digital workflows in our treatments can contribute with many of the advantages that immediacy also provides, while increasing the precision and quality of the results; and more importantly, reducing the risk of the spread of the so known COVID-19, as the communication with the dental lab can be done digitally, from the planning to the manufacture of the final restoration. �b�} ؄.zC��������(C �L� ���dEA��P+�Χ�{��U����@� �16�@�Cz6$$�-�����ȝi��� The smile also revealed that the lateral incisors were different in shape and the left upper deciduous canine was shorter, narrower and more yellowish in color in comparison to the contralateral permanent canine (Fig. Fig. 8: The functional analysis revealed that the canine guidance was given by lateral incisor and first premolar whilst the deciduous canine was not involved. lateral incisors is clear. Fig. Once this step was completed, the zirconia crown was produced using this as a reference (, Meanwhile the ceramic veneer for tooth 12 was also prepared and ready to be cemented. Fig. 0000274246 00000 n Fig. The analysis of the smile presented the midline sagittal plane coincident with the medium line of smile, and the exposure of the upper incisors and canines was 90% (, In the intraoral examination, a good amount of keratinized gingiva was observed by the deciduous tooth and a good overall oral hygiene was presented (, The functional analysis revealed that the canine guidance was given by lateral incisor and first premolar whilst the deciduous canine was not involved (, The radiographic evaluation with a Cone Beam Computed Tomography (CBCT) showed the extremely reduced root of the deciduous canine, the presence of an impacted left upper permanent canine and a thick cortical bone and adequate trabecular bone in the deciduous tooth site, as well as the feasibility of placing there an implant (, We evaluated each of them considering the patient’s needs. Finally, a risk profile will be created according to the provided data. 22-24). As we were seeking for the most conservative and efficient approach, our preferable option was to place a post-extractive implant and provisional restoration in the site 23 leaving the permanent impacted canine in its position, as this allows a shorter treatment time and a better patient morbidity and esthetics (, Within the treatment planning, it is also fundamental to identify and consider the degree of complexity and potential risk involved in the case. The functional analysis revealed that the canine guidance was given by lateral incisor and first premolar whilst the deciduous canine was not involved (Fig. 34). ѹ Less plaque attachment on zirconia due to smoother surface compared to titanium. 2-4). (Fig. Clinical cases like this one are also supported by Straumann® Smile in a Box™ - a flexible treatment planning and manufacturing service. tӇ��sFB��8���a����{3k�{�t�h�٧��CA�. The amount of keratinized gingiva will also allow to start the soft tissue conditioning around the canine at the time of the provisional crown placement. trailer <]>> startxref 0 %%EOF 202 0 obj<>stream WS Line. Implant or Abutment Level Abutment Level (8) Implant Level (3) 0000007800 00000 n Zirconia; Literature and Marketing; Implants and Abutments; Refine. 31: Printing of the surgical protocol. Restoration. 03/14 490.028/en/B/001. Straumann® PURE Ceramic Zirconia Implant. in Straumann history! Zirconia Dental Implants – 100% Metal-Free Implants Placed & Restored by Dr. Yuriy May The superior alternative to traditional, metal dental implants, are the newer, FDA approved, durable, beautiful, biocompatible, biomimetic ceramic, metal free zirconia dental implants otherwise known as … 1: View of the patient before the treatment. A denture set up was fabricated and sent to the doctor for try-in. 26-28). Smile makeover at first stage! 61: After the tightening of the crown at 25 n/cm, the screw head was protected by using a teflon floss and the screw channel was filled with composite. 0000013812 00000 n Straumann recently developed the BLT ∅ 2.9 mm, which has the advantage of being fabricated with Roxolid – a metal alloy composed of 15% zirconium and 85% titanium that has higher tensile and fatique strengths than comparable titanium implants, and has excellent osseointegration and biocompatibility properties. Nowadays, patients are more conscious of their health and esthetics than ever before. 40: Despite the reduced amount of available bone, it was possible to reach a 35 n/cm torque value for the implant stability. Clin Implant Dent Relat Res. Autori: Roberto Sorrentino Fabio Cozzolino. CM Line. Retrospective radiographic observational study of 1692 Straumann tissue-level dental implants over 10 years: I. Implant survival and loss pattern. This represents the plan to be used during implant placement. Fig. Auxiliary Parts and Screws RB. Fig. As a first step, the mock-up was made once again and a silicon mask, created on top of it and cut in the middle, was used as a guide during the preparation of the tooth. Clinical cases like this one are also supported by, In the extraoral examination, the facial evaluation showed a symmetrical and proportional face. 22: Lateral view of the printed model: Note that the shape of the provisional canine crown is now in line with the adjacent teeth. Fig. The radiographic evaluation with a Cone Beam Computed Tomography (CBCT) showed the extremely reduced root of the deciduous canine, the presence of an impacted left upper permanent canine and a thick cortical bone and adequate trabecular bone in the deciduous tooth site, as well as the feasibility of placing there an implant (Fig. 45). Straumann® Mini Implants. Fig. More than a restoration. Both final restorations were received in a printed resin model, that allowed us to visualize the final result (, For the cementation of ceramic veeners, it is fundamental to have an absolutely dry area. �tNZ2�0&2�c1l�,`��K��7�˜p�����`GG[ZFG�`R� Q�����@?�#H,�2d��F�Ɍ�� &��� . Fig. 0000002009 00000 n 5.    Execution of the provisional crown by dental lab on the basis of digital wax-up (on resin printed models) (Fig. '�H��Tmԍ���Ȱ��4m��O;3n��N8��tk_V;�a�W|��j���ڑ�Re�b�(g���rV�FXU�L���C������za�� EB�M��u�dL�)Ը�=�p���G{�S �~2�f�KZ:���`;3"L%L���ƭ������q�����g����q��y*C�ǁ"�F���[�3B��� g��%���9�#���hQX(�}l|� ���L!�HACh�0 ���l��� 0000001446 00000 n Healthy-looking oral soft tissues and bright teeth are considered a prerequisite for a beautiful smile and self-esteem, adding directly to a health-related quality of life (Bennadi and Reddy, 2013; Klages et al., 2004; Pithon et al., 2014). 9: Cone Beam Computed Tomography (CBCT) exam shows the presence of the impacted canine. 49: Final digital impression: a screenshot of the data acquisition with the intraoral scanner DWOS. Mandibular full-arch restoration with Straumann implant-supported metal mesostructures and zirconia-based prosthesis: a case report. Facility Line. Fig. 3.    Processing of Dicom (CBCT exam) and STL (optical impression and digital wax-up) data in coDiagnostiX® planning software in order to carefully plan the implant placement and design surgical guide. Implant or Abutment Level Abutment Level (9) Implant Level (8) 14). For this, the tooth 12 was prepared using a silicon mask as a guide: first of all, the initial mock-up was recreated and then the silicon mask (made on top of it) was used to verify the thickness needed for the ceramic veneering (, Afterwards, digital impressions using the Virtuo Vivo™ intraoral scanner were taken, and with this objective a dedicated scan body was screwed on top of BLX® implant and a retraction cord was placed around the tooth 12 in order to mark the line preparation (, Then, the STL files related to the impressions were imported in the Dental Wings lab modeling software. Study models were sent to Burbank Dental Lab. Once this procedure is completed, the zirconia crown will be produced on the basis of this project. It features high tensile strength and excellent osseointegration capabilities, making it the material of choice for reduced invasiveness. … full zirconia implants available in two parts. Afterwards, the chimney of the provisional abutment was protected with a cotton pellet to avoid during the further steps the occlusion of the access to the screw. 66: New smile is harmoniously integrated in the patient’s face. In the extraoral examination, the facial evaluation showed a symmetrical and proportional face. The customized provisional abutment with a diameter of 3,8mm and a gingival height of 1,5mm was screwed on top of the implant (Fig. 0000007283 00000 n It’s important to understand that while zirconia dental implants are VERY strong, they have less flexural give than a metal alloy implant. �Bc4Ş 4: Left lateral view of the patient’s smile. Fig. Despite the reduced amount of available bone, it was possible to reach a 35n/cm torque value for the implant stability and this allowed the placement of an immediate prosthesis (Fig. 21: The guide seated on the printed model to verify the precision of the procedure. 27: The extraction resulted in a simple procedure being the root of the tooth almost completely reabsorbed. One-piece zirconia implants with an integrated abutment and predetermined restorative margin have limitations due to their inability to allow for angle correction, require a high degree of surgical precision, and only accept a cementable restoration. 65-66) and finally, she was involved in a maintenance program for follow-up visits once per year. Following the milling of the zirconia crown and the ceramic veenering, the crown was cemented on the Variobase® using a composite cement (Fig. �d;Y^(�=/�,�-�0�^W&�7ʰ��ڧ�wJu���B��Z�Q�vr��Ry;�'�Ky����e(a;��i�O���2�=�ҳ������̾w@���y b ������r����'����A�����0�9�\�]D��y-ɖ����k�v����4(���k`;���ҔP��Oi��S���X��pc�L����7��l�xy��KA&?�HJzA�i?L�C�G�4���BX�2�ؓ�ڼ�N�=��_��'�����U�d����}�*;��&wG6Jg�o�S��B���S��d���{����Ӊ����Șn="��9D�u The main vision of the company is to restore patient’s oral esthetics and oral function with the help of safe, reliable and effective procedures. 44: After the refinements, occlusion was checked in the patient’s mouth. Fig. 0000022442 00000 n c. Extraction of the deciduous tooth and positioning of an implant in the existing bone with immediate prosthesis with the aim of maintain a favorable esthetic appearance. Afterwards, the tooth was conditioned protecting the adjacent teeth and the ceramic veener was cemented using a flowable composite (Fig. N9���%]�Ι����\(��+yg� 8). 0000010448 00000 n Fig. The Straumann® Ceramic Healing Abutments offer favorable conditions for soft-tissue attachment, hereby supporting a healthy peri-implant environment. 46: Note the nice emerging profile of the temporary crown; ready for the final prosthetic phases. 55-56). Both final restorations were received in a printed resin model, that allowed us to visualize the final result (Fig. B��LJ���ʇ(�a�LIR1�;P+�i�T��x@�����i?�%��c}`�t. 39: Occlusal view after the implant placement and the removal of the guide. Within the SAC Classification, this specific case was considered as “complex” (. 59: Acid-etching of enamel: Note how the adjacent teeth were protected from the injury of the acid. 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