A 52-year-old female presented with unremarkable health history. Her chief complaint was dissatisfaction with her maxillary incisors as the old crowns had debonded several times and the gingiva surrounding the teeth was puffy and unhealthy.
The initial treatment was extraction of teeth Nos. 7, 8, 9, and 10. Socket preservation procedures were done on teeth Nos. 8 and 9. Immediate placement of Straumann NC Bone Level Implants (Straumann) was accomplished in teeth Nos. 7 and 10, and autogenous bone grafting with resorbable membrane was used.
When the provisional abutments were completed, Drake Precision Dental Laboratories fabricated a provisional Radica bridge to provide pleasing esthetics and appropriate occlusion. This provisional restoration and abutments were returned to the clinic and placed using Integrity temporary cement (DENTSPLY Caulk).
The patient was recalled after 3 months for an evaluation. The temporary bridge was removed and open tray impression copings (Straumann) were modified with flowable composite (SureFil SDR flow, DENTSPLY Caulk) to create "custom impression copings." The final impression was taken with a vinyl polysiloxane material (Panasil Heavy and Extra Light, Kettenbach). Complete prescription and pertinent clinical photography was included to provide complete communication with the laboratory.
The case was returned from the laboratory ready for delivery. The abutments were tried in and torqued to place. The bridge was then luted in place using a self-curing luting composite cement. (Multilink Implant, Ivoclar Vivadent). All vestiges of cement were removed and the final marginal adaptation was evaluated with radiographic confirmation. The patient was postoperatively evaluated at 1 week and at 3 months. Postdelivery follow-up was uneventful. The patient enthusiastically endorsed the treatment and was extremely pleased with the final outcome of treatment.
The author would like to thank the technicians at Drake Precision Dental Laboratory for their enthusiasm and attention to detail. The patient's expectations were not only met, but also exceeded. He would also like to thank Dr. Yelena Brikina for her participation in this case.
