logo 17 • CAMLOG Partner Magazine • March 2018 without gingiva masks, as we want to transfer the surgically and prosthetically elaborately formed gingival margin exactly as a defined limit to the model, a purpose for which resilient gingival masks are not indicated (Fig. 30). The zirconium crown framework was milled (Cercon ht light, Degudent, Hanau) and veneered with ceramic materials (Cercon ceram Kiss, Degudent, Hanau). By powdering neutral, highly-fluorescent ceramic materials onto the framework, all the necessary light properties can be imparted with minimal layer thickness. Shade selection beforehand in the laboratory is of crucial importance because up to 20 shades and mixed hues are required for the individual esthetic design of anterior tooth crowns (Fig. 31). The shade nuances were determined directly on the patient and transferred into an esthetic layering scheme (Fig. 32). [3] The crown fabricated in this way was cemented and the clinical gingival conditions were documented with photos as a reference after one month in situ (Fig. 33). The clinical follow-up was performed after 15 months (Fig. 34): The result of the esthetic rehabilitation with a single-tooth crown implant after bone and soft tissue regeneration and soft tissue forming is reliably stable and the patient is fully satisfied with the esthetics and function. Discussion/ Conclusion The present patient case describes the detailed course of treatment of an esthetic anterior tooth rehabilitation after tooth loss, loss of parts of the alveolar process due to an extensive cyst, and the gradual regeneration of hard and soft tissue as a prerequisite for implant surgery and prosthetic therapy. The sequence of treatment steps, which can extend over one year, must be strictly coordinated in terms of time in order to eliminate delays and to allow sufficient time for the biological regeneration processes in particular. This requires applying a comprehensive therapy plan in the form of a standardized protocol, which sets milestones for the treatment, which are then adapted to the individual patient case. For this purpose, the surgical, prosthetic and dental work steps are worked out in an interdisciplinary conference and, after Fig. 25: Individual healing cap on the model. Fig. 31: Individual shade guide for shade selection for the patient. Fig. 34: Follow-up after 15 months shows perfect biological and prosthetic conditions. Fig. 26: Frontal view of the individual healing cap in situ. Fig. 32: The patient’s layering scheme for shade customization of the implant crown. Fig. 27: Occlusal view of the individual healing cap with anatomically optimal emergence profile. Fig. 33: Inserted implant crown after one month. 17 CASE STUDY
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