logo 19 • CAMLOG Partner Magazine • December 2018 16 CASE STUDY term stable anterior tooth reconstruction with a healthy fixed gingiva and the harmonious contour of the gingival garland (Figs. 28 and 29). Conclusion Esthetic maxillary anterior reconstruction is one of the greatest challenges in dental implantology. When extracting non-sustainable teeth, it is important to preserve the intact facial lamellae or to regenerate both the alveolar ridge as well as the alveoli by augmentation. The stabilization of the bone lamella around implants with slowly resorbable bone substitute materials has proven successful. The design of the subgingival abutment portion plays a decisive role for the long-term stability of the esthetic result. The individually fabricated CAD/CAM zirconium abutments support the periimplant soft tissue, are biocompatible and reduce the risk of inflammation around the implant/abutment interface. The emergence profile is determined by the anatomically correct design of the superstructure and contributes significantly to the harmonious overall impression of the reconstruction. The prosthetically oriented placement of the implants and the indication-related design of the abutments optimally transfer the occurring chewing forces to the internal configuration of the implants and prevent damaging shearing forces on the implant neck. This supports periimplant bone preservation and promotes gingival adaptation. Fig. 28: In the follow-up after three years, the anterior tooth reconstruction is stable. Fig. 29: The clinical picture at the follow-up shows the healthy fixed gingiva and the harmonious contour of the gingival garland, which was supported by contouring the gingiva with a diamond for the bridge support prior to the insertion of the reconstruction. Fig. 25: With the help of analog abutments, excess cement was removed before insertion and surplus cementing was avoided. Fig. 26: After the functional and esthetic check, the bridge was inserted definitively to the satisfaction of everyone involved. Fig. 27: The X-ray control image at the time of insertion.
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