The natural CAD/CAM anterior implant single tooth restoration: A novel digital workflow.

OBJECTIVE: To report a novel digital workflow to replace an anterior maxillary tooth lost due to trauma with an implant multilayer restoration by using the patient's extracted tooth as a final crown restoration using computer-aided design/computer-aided manufacturing (CAD/CAM) technology. CLINICAL CONSIDERATIONS: Instead of using the patient's natural tooth as an immediate provisional restoration to achieve predictable results in terms of esthetics and soft tissue structure, a novel digital strategy was performed to obtain a natural final crown restoration by using the patient's tooth associated with a lithium disilicate customized implant abutment. CONCLUSIONS: The perspective of using this strategic approach for implant restorative dental treatments in patients with traumatic root fractures in the anterior region has great potential as it helps to maintain the emergence profile of the natural dentition and esthetics. CLINICAL SIGNIFICANCE: Optimal esthetic outcomes are challenging in implant dentistry regarding soft tissue structure and morphology factors. Using natural teeth from surgery to deliver the final restoration might be beneficial when an anterior tooth is lost due to trauma.

Transferência precisa da morfologia do tecido mole peri-implantar em prótese anterior: relato de caso / Accurate transposition of peri-implant soft tissue morphology in anterior prosthesis: case report

O perfil de emergência em próteses implantossuportadas é a porção da restauração que emerge coronalmente do implante até a gengiva marginal livre, visando conferir suporte e estabilidade ao tecido mole peri-implantar, mimetizando o dente natural. As restaurações com contornos apropriados têm um efeito significativo na higiene bucal, saúde do tecido peri-implantar e estética. O maior desafio para a confecção de próteses implantossuportadas definitivas está na duplicação do perfil de emergência obtido com a prótese provisória para o modelo de trabalho, sendo que há várias técnicas publicadas, porém não há um consenso na literatura sobre qual método é mais preciso. O objetivo do presente estudo é apresentar, por meio do relato de um caso clínico, uma técnica de moldagem do perfil de emergência e tecido peri-implantar...

The emergence profile for implant-supported prostheses is the portion of the restoration that emerges coronally from the implant to the free gingival margin, giving support and stability to peri-implant soft tissues and mimicking the natural tooth. Restorations with appropriate contour have a significant effect on oral hygiene, health and esthetics of peri-implant tissues. The greatest challenge involved in manufacturing permanent prosthesis is the duplication of the emergence profile obtained with the provisional restoration secured to the cast. Several techniques have been published, but no consensus has been reached on the literature regarding which method is the most accurate. The objective of this study is to present a technique for molding the emergency profile and peri-implant tissues by presenting a clinical case...

Cimentação adesiva de laminados cerâmicos E. max / Adhesive cementation of E. max ceramic laminates

A etapa de cimentação é de fundamental importância para o tratamento restaurador usando laminados cerâmicos. É nessa etapa que normalmente são verificados os erros e acertos nas etapas anteriores de planejamento, preparo e moldagem dos laminados. É fundamental que o dentista conheça essa etapa, desde o tratamento da superfície interna da restauração cerâmica até o preparo do substrato dental para a técnica adesiva. Dessa forma, o objetivo desse artigo é mostrar de forma segura a cimentação de laminados cerâmicos reforçados por dissilicato de lítio, o que garante um resultado final satisfatório do tratamento conservador estético

Immediate implant placement and restoration in the esthetic zone: a prospective study with 18 months of follow-up.

PURPOSE: This clinical study aimed to assess the dimensional stability of peri-implant soft tissues around immediately placed and restored implants in the maxillary esthetic zone. MATERIALS AND METHODS: Twelve systemically healthy patients presenting with a hopeless maxillary central incisor were selected. Provisional restorations were delivered immediately after tooth extraction and implant placement. Periimplant soft tissue dimensions were measured either by direct clinical examination or evaluation of study casts. Measurements were performed before extraction; immediately after implant and restoration placement; and 6 weeks, 3 months, 6 months, 12 months, and 18 months postoperatively. The distances assessed were: tip of the mesial papilla to the mesioincisal edge of the adjacent central incisor, tip of the distal papilla to the mesioincisal edge of the adjacent lateral incisor, and the length of the clinical crown of the definitive restoration. RESULTS: All patients completed the study, and no implants failed within the 18-month follow-up period (100% survival rate). No statistical differences were observed in the distances between the incisal edge of the adjacent teeth and the mesial and distal papilla tips (P = .303 and .099, respectively) at any follow-up appointment. Likewise, there were no alterations in the definitive clinical crown dimensions during the follow-up period (P = .406). CONCLUSION: The findings of this 18-month prospective study indicate that, within the selection criteria and technique presented in this study, immediate implants with immediate restorations can be a predictable option for the replacement of teeth in the esthetic zone, providing stability to the peri-implant soft tissue.