Page 20 - CEREC Q1 | 2014

18 | CERECDOCTORS.COM | QUARTER 1 | 2014
Fig. 5: Pre-op model
Fig. 6: Pre-op model with virtual
restoration
Figs. 7-8: Implant planned
Fig. 9: Implant placed
Fig. 10: Screw-retained provisional
Fig. 11: Recreation of papillae by
provisional
| | | S K R A M S TA D
five shades (MO 0, MO 1, MO 2, MO 3
and MO 4) depending on the color of
deep dentin desired. The A16 LT block
is primarily used for hybrid abutment
crowns. Since the restoration is thicker, a
lower translucencywill work to block out
the TiBase and produce esthetic restora-
tions. The LT abutment block comes in
10 shades. Examples of hybrid abutments
and hybrid abutment crowns can be seen
in Figure 4.
It was discussed earlier that there is a
precision attachment between the e.max
CAD abutment blocks and the Sirona
TiBase. These parts are also chemically
bonded using Multilink Hybrid Abut-
ment, a self-curing luting composite
developed by Ivoclar Vivadent for this
specific purpose. It comes in two levels
of opacity (MO or HO) and produces
high bond strengths for reliable results.
In the following case study, we will go
through a hybrid abutment crown case
on tooth #10, start to finish, illustrating
how this process works clinically.
CASE STUDY
A 55-year-old male presented with a missing lateral incisor
(#10). He stated that he recently had the tooth taken out by
another dentist, and was referred here for an implant resto-
ration. After reviewing his medical history and performing a
full clinical and radiologic exam, we gained consent to begin
treatment.
Using the CEREC Omnicam, the upper arch was scanned
at his initial consult appointment and a virtual restoration
was designed in the #10 edentulous site (Figs. 5-6). This
virtual arch and restoration was integrated into a 3-D cone
beam scan (Sirona ORTHOPHOS XG3D), and the implant
was precisely planned using Sirona proprietary implant-
planning software (Figs. 7-8). The advantage of integrating
the CEREC scan into the 3-D scan
is that we can place the implant in a
position that best supports the planned
final restoration. The plan also allowed
me to visualize that the screw access
for the final restoration would very
likely be on the lingual of this lateral
incisor, thus enabling me to plan for a one-piece hybrid
abutment crown.
The implant plan described above was sent digitally to
SICAT for production of an OPTIGUIDE. This would be
used for a fully guided implant placement using an Astra
Tech Osseo Speed 3.5 implant (DENTSPLY Implants) on
appointment #2 (Fig. 9).
Due to excellent primary stability of the implant at surgery,
an immediate, non-loading, screw-retained provisional
was milled to a stock titanium base. Care was taken with
the provisional to create contours that would best develop
papillae during the healing phase (Fig. 10).
After four months of healing, the implant was ready to
5 6
7 8
9 10
11