A 53-year-old female presented to my office with tooth No. 7 loose. She previously had all-ceramic crowns done on teeth Nos. 6 to 11. Tooth No. 7 had a root canal, post, and core. On examination, I found that this entire post/core complex was loose. After I removed the restoration, I also found unrestorable decay present because of leakage.
The patient and I agreed that the treatment plan was to restore her implant.
Treatment for this case began by digitally planning the implant using GALILEOS 3D cone beam system (Sirona) and the GALAXIS implant planning software (Sirona). Fully guided implant placement was instrumental in the correct implant placement that allowed ideal temporization and fi nal restorations.
I extracted tooth No. 7, then immediately placed OsseoSpeed TX 4.0 implant (DENTSPLY Implants) and immediate temporization. The provisional was then screw retained and milled using Lava Ultimate CAD/CAM block LT (3M ESPE). The provisional was in place for 4 months. Afer 4 months, the fi nal restoration was created completely digitally with the use of the Scanbody (Sirona), tiBase (Sirona), a milled abutment (Sirona), and IPS e.max CAD (Ivoclar Vivadent) as the restorative material for the final restoration. I also used Multilink Implant (Ivoclar Vivadent) to bond the zirconia custom abutment to the titanium base.
This case truly represents full digital integration and prosthetically driven execution when restoring implants. The patient?s implant was restored without the use of impressions, tissue retraction, or preparation of the abutment. Additionally, the case was completed in less than 30 minutes of chair time and with a total cost (both custom abutment, parts, and crown) of $220.
Digital implant dentistry gave me the best of both worlds; I had total control of the case and I lowered the cost of treatment for the patient. CEREC AC (Sirona), inLab Software 4.0 (Sirona), inLab MC XL (Sirona), and CEREC Bluecam (Sirona) allowed me to create custom abutments based on my full contour design. I was able to work from the top down rather than trying to fi gure out the fi nal restoration based on the abutment.
The patient and I were satisfied with the outcome of this case.