logo 49 | The Camlog Partner Magazine Case study | 25 1. In a 69-year-old patient suffering from bruxism, the anterior tooth fractured to gingival level despite being splinted. Tooth preservation appeared possible but did not seem to offer a long-term prognosis due to an inadequate ferrule effect. The incisal edge of the lithium disilicate crown on tooth 11 had chipped off due to grinding. 3. For correct implant planning, the crown of the fractured tooth was first fixated with plastic. A digital impression for 3D implant planning was followed by an alginate impression for manufacturing a deep-drawn splint, which was bonded with a fractured crown and used as a temporary restoration. For manufacturing the screw-retained temporary restoration on the day of surgery, the dental technician based his work on the shape and shade of the original. 5. Based on the virtual wax-up, the ideal prosthetic emergence profile was first determined and then the exact positioning of the implant was determined for all three planes. A drilling template was then designed and immediately created in the practice using a high-quality 3D printer. 2. No changes or signs of fracture were displayed radiologically on the root remnant. The bundle bone was radiographically well visible and fully preserved. Implantation was to be performed according to the socket shield technique. By leaving a root remnant in the crestal area, the periodontal ligament and bundle bone were to be preserved to avoid resorption processes of the facial bone lamella following tooth extraction. 4. A CBCT scan was performed to plan the 3D implant position (Planmeca Promax 3D Plus). Particular attention was paid to the integrity of the cortical plate and adequate bone volume in the apical region. By superimposing the intraoral scan data of the maxilla and mandible (3Shape, TRIOS), exact placement of the implant position was determined in terms of backward planning. 6. After local anesthesia, the drilling template was placed and a pilot hole was drilled through the root of the tooth. To allow a good view of the surgical site, a very small-sized buccal full flap was mobilized by flap preparation whereby the papilla preserved, under consideration of biologically induced tissue resorption. The root was halved vertically.
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