logo 19 • CAMLOG Partner Magazine • December 2018 15 Fig. 22: The crown margin was placed 0.5 mm to 1 mm below the mucosa border in order to remove cement residues effortlessly. Fig. 19: The zirconium dioxide abutments were fabricated using the CAD/CAM process and bonded to titanium bases. Fig. 23: Due to the anatomically shaped emergence profile, the peri-implant mucosa was displaced vestibularly with slight pressure. Fig. 20: The zirconium dioxide bridge framework was designed digitally, milled and fully veneered with corresponding zirconia materials. Fig. 24: The soft tissue was supplied with blood after a short time. The oral view shows the anatomical shape of the augmented jaw region. Fig. 21: The subgingival part of the abutments and the “ovate pontic design” design of the bridge pontic support an esthetic crown emergence profile. CASE STUDY the subgingival part closely resembles the natural appearance of a tooth. The abutment design was created digitally, fabricated using a CAD/CAM process and bonded to titanium bases. The crown margin was placed 0.5 mm to 1 mm below the mucosal border so that the cement could be removed effortlessly when inserting the bridge. Then the zirconium bridge framework was designed digitally, milled and fully veneered with the corresponding zirconium materials (Figs. 18 to 21). The definitive implant restoration was inserted in mid-December 2015. After the gingiva formers had been removed, the internal configurations of the implants were rinsed and the hybrid abutments screwed in. Due to the submucous anatomical shape of the emergence profile, the round shaped peri-implant mucosa was displaced vestibularly with slight pressure (Figs. 22 to 24). A diamond was used to contour the gingiva for the pontic support in the form of an ovate pontic. The peri-implant gingiva was well supplied with blood after approximately ten minutes. After checking the esthetics, function and phonetics, the bridge was integrated definitively to the satisfaction of all concerned (Durelon, 3M Espe, Herrsching). With the help of analog abutments, excess cement was removed before insertion and surplus cementing was avoided (Figs. 25 to 27). In the follow-up after three years, both the control X-ray and the clinical image show the successful esthetic and longFig 13: To avoid unfavorable pressure during the swelling phase, the interim prosthesis was shortened in the anterior region. Fig. 15: The augmented anterior tooth region presented itself with an anatomically shaped contour prior to exposure surgery. Fig. 14: After healing without complications, a stable soft tissue situation was observed two weeks postoperatively.
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