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Fig. 10: The hybrid abutment crownwas seated, then torqued to 35Ncm
easy retrievability should it require removal for any reason. By not
requiring intraoral cementation of the restoration, this treatment
also eliminated the potential for cement sepsis from incomplete
subgingival cement removal, which can result in a higher preva-
lence of implantitis and implant failure after implant restoration.
The final lithium disilicate hybrid abutment crown on tooth #13
demonstrated exceptional esthetics, stability and functionality. It
also achieved ideal occlusion and blending with the gingiva and
surrounding dentition (Fig. 12).
CONCLUSION
At-risk teeth previously treated endodontically can present challenges
for dentists when determining the appropriate treatment plan. There-
fore, a thorough understanding of treatment and material options
ensures that dentists can identify appropriate solutions to reduce risk
and improve a patient’s long-term prognosis. Although endodontic
retreatment is an option, extraction is frequently necessary. Compared
to fixed bridges or removables, restored dental implants provide
comfort, functionalityandenhancedesthetics. Byavoiding theneed for
intraoralcementationtoretaintherestorationand/orabutment,screw-
retained hybrid abutment crowns eliminate problems associated with
excess cement and peri-implant tissues. Additionally, they represent a
treatment alternativedemonstratingnatural esthetics, one that enables
in-office fabrication, quality control and cost effective predictability.
For questions and more information, Dr. James can be reached at
.
Fig. 7 (left): The final restoration was milled from a size 16 lithium
disilicate abutment block in shade A3 LT (IPS e.max CAD
Abutment, Ivoclar Vivadent)
Fig. 8 (center): Restoration stained and glazed
Fig. 9 (right): The titanium-base and hybrid abutment crown were
cemented together and held in place for 7 minutes
Fig. 11: The screw-access hole was filled
Fig. 12: View of the final lithium disilicate hybrid abutment crown in
occlusion at #13
