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The patient is extremely satisfied with both the result and the cost-effect relation. Appropriate design of the emergence profile, the titanium abutment and the zirconium bridge entirely fulfil the esthetic requirements of the visible areas. In the event of later loss of the second molars the patients wishes to undertake prosthetic restoration of the ensuing end gap situation. As shown here, in cases of compromised bone and in consideration of the esthetic zone and CADCAM-made elements of different materials, the use of NNC implants can lead to very positive results.
Straumann® MembraGel could be used successfully in the technique presented for flapless socket seal. The liquid application procedure for bone graft coverage facilitated the surgical workflow. The early post-surgical evaluation showed an excellent soft tissue response accompanied by early wound closure. The soft and hard tissue could be preserved satisfactorily facilitating the subsequent implant insertion procedure.
In this case, the virtual planning models and the actual outcome (Fig. 30) demonstrated that the Straumann® Guided Surgery System ensures a high level of precision for the purposes of implant positioning.
To achieve the most accurate results, a guided implant insertion is recommended. This case was treated with Straumann® Soft Tissue Level Implants, according to the routine protocol for lateral-posterior rehabilitations. As a further consideration: in the author’s opinion selecting Straumann® Bone Level Implants is the best way to maximize the benefits of the system, potentiality making it easier for the clinician when it comes to soft tissue management (especially for flapless procedures) and providing a wider range of options for prosthetics.
Combined with the ability to perform a predictable and safe flapless procedure, one interesting indication for the Straumann® Guided Surgery system is potentially the
bypassing of anatomical structures which – in carefully selected cases and in the hands of experienced clinicians – can reduce or eliminate the need for bone augmentation and the associated treatment complications.
This clinical case yielded satisfactory results. In 12 months, the patient obtained complete restoration of the left posterior hemiarch. At the control visit after 2 years the radiograph demonstrates an absence of pathological peri-implant changes (Fig. 16).
No bone resorptive patterns of the peri-implant bone sites can be seen when compared to the situation at time of implant placement. The preservation of the generated bone volume in the sinus cavity could be confirmed 5 years post-op by a DVT at a follow-up visit (Fig. 18).
The employment of Straumann® BoneCeramic for sinus grafting, as well as lateral recontouring for the deficient bony site, has been demonstrated to be very useful;
this article confirms the data on the osteoconductive properties of Straumann® BoneCeramic.
The application of ceramic abutments, especially in combination with full-ceramic restorations, has the potential to achieve highly esthetic and biocompatible restorations. The benefits for the incisor area could be clinically confirmed in a number of studies conducted in recent years. There are currently no long-term results for the application of this type of structure in the lateral tooth area. However, first experiences appear promising. The production of single-unit zirconium dioxide abutment usually requires complex CADCAM technologies. The case presented here is an excellent demonstration of treatment with industrially prefabricated, individualized ceramic abutments in both the front and lateral tooth areas.
Situation: In February 2010, a 42-year-old non-smoker with a congenitally missing upper right lateral incisor was referred by her orthodontist for a consultation prior to orthodontic treatment