Fig. In the extraoral examination, the facial evaluation showed a symmetrical and proportional face. The following case report describes the procedures of a complete smile makeover in a young lady with very high expectations. As described in the instructions for use, the drilling procedure was carried out until the stop, located on the drill itself. 9-10). Straumann PURE Ceramic Implants can be placed using the existing instruments using the same 21: The guide seated on the printed model to verify the precision of the procedure. Fig. �Bc4Ş 20: In accordance with the STL file produced in coDiagnostiX®, the surgical guide was printed. lateral incisors is clear. 65-66) and finally, she was involved in a maintenance program for follow-up visits once per year. Implant or Abutment Level Abutment Level (9) Implant Level (8) 51). c. Extraction of the deciduous tooth and positioning of an implant in the existing bone with immediate prosthesis with the aim of maintain a favorable esthetic appearance. 39). 0000250494 00000 n 13: Following the SAC Classification, this specific case is considered as “complex”. For the cementation of ceramic veeners, it is fundamental to have an absolutely dry area. After the adjustments, the temporary crown was placed in the patient’s mouth (Fig. in Straumann history! The ideal emerging profile of the temporary crown was therefore ready for the final prosthetic phases involving the implant-supported crown of left canine and the ceramic veneer of right lateral incisor. 0000002009 00000 n 33: Use of pilot drill (2.2 mm diameter). 51: Modeling of the zirconia crown to be veneered after milling on the vestibular side with ceramic. 0000002168 00000 n 55: Printed resin model with ceramic veneer and crown in position. 39: Occlusal view after the implant placement and the removal of the guide. The main vision of the company is to restore patient’s oral esthetics and oral function with the help of safe, reliable and effective procedures. Fig. Fig. Fig. Straumann® Ceramic Healing Abutments. 25: Anesthetic infiltration in the area corresponding to the canine apex. 46). Finally, a risk profile will be created according to the provided data. Fig. Status: | Dentsply Sirona, ( previously Astra) Implant System is … 1.    Preliminary data acquisition: intra and extra oral photos, digital impressions (DWOS Virtuo Vivo ™) and CBCT exam. I have been purchasing and using implants and implant parts from Titan Implants in Bergenfield, New Jersey since March 2003. 22-24). For detailed information regarding implantation and soft tissue management, please refer to the Basic information on the surgical procedures – Straumann® Dental Implant System, 152.754, or the DVD Surgical and prosthetic procedures with the Straumann® Bone Level Implant, 150.760. Commercially available zirconia implants can be one- or two-piece. Name * Description. 49: Final digital impression: a screenshot of the data acquisition with the intraoral scanner DWOS. The functional analysis revealed that the canine guidance was given by lateral incisor and first premolar whilst the deciduous canine was not involved (Fig. Fig. 41). Fig. Temporary Restoration RB. Within the treatment planning, it is also fundamental to identify and consider the degree of complexity and potential risk involved in the case. 14). The Straumann PURE Ceramic Implant is a dental implant made out of yttrium-stabilized zirconium dioxide (Y-TZP). As a first step, the mock-up was made once again and a silicon mask, created on top of it and cut in the middle, was used as a guide during the preparation of the tooth. Once this step was completed, the zirconia crown was produced using this as a reference (Fig. Then, the modeling of the zirconia crown to be veneered after milling on the vestibular side with ceramic was performed. These included an immediate implant placement into a fresh extraction socket and immediate implant loading to replace a hopeless upper deciduous canine. The margin of the LoCaToR®abutment must be positioned supra-gingivally. Once this procedure is completed, the zirconia crown will be produced on the basis of this project. 46: Note the nice emerging profile of the temporary crown; ready for the final prosthetic phases. B��LJ���ʇ(�a�LIR1�;P+�i�T��x@�����i?�%��c}`�t. At this point we could say that we cover all our patient’s needs and expectations and we can appreciate a big improvement in comparison to the baseline situation (Fig. Fig. Following guide placement and verification of the fit, the dedicated set of surgical instruments were ready to use (Fig. … Straumann has just provided two-piece ? 59-60). Smile makeover at first stage! We evaluated each of them considering the patient’s needs. 66: New smile is harmoniously integrated in the patient’s face. CM Line. Nowadays, patients are more conscious of their health and esthetics than ever before. Fig. The specific handle reduces the dimension of the sleeve to those of the selected drill. Fig. 58: A detail illustrating the finishing line of the preparation: It was perfectly visible and ideal for a correct cementation procedure. 47: The lateral incisor was treated with veneer to improve esthetics and avoid ortho treatment. 12-13). After the extraction, the surgical guide was placed in the patient’s mouth as it is important to verify the stability and the precision of it through the windows created into specific locations (Fig. Fig. zirconia compared to titanium³-⁷ | Designed for healthy peri-implant environment. 25).  The extraction of the deciduous tooth resulted in a simple procedure being the root almost completely reabsorbed (Fig. 43). It started by using the milling cutter bur in order to create a flat surface for the precise work of the further drills (Fig.32), followed by the pilot drill (2.2mm diameter) (Fig. 54: Palatal view of the final crown. Fig. Fig. 17: It is important to analyze the integration of new tooth shapes in the patient’s face. Zygomatic Line. �G�n�79�dNjl�I�v7�2��W�O#��3��G���N�� 2y� �)�6�% 44) and post-op X-rays images were taken in order to ensure the precision of the implant and the provisional restoration (Fig. 32: After the guide placement, the milling cutter bur was used with the purpose of creating a flat surface for the precise work of the further drills. At the 3- month follow-up visit, the patient presented with an outstanding healing of the soft tissues and referred having no complications within the previous months (Fig. 12: Tool evaluation – SAC classification. The implant was virtually inserted into the model and the Variobase® was seated on top of it. 11). After a proper healing period, tooth #12 was to be extracted, and after a socket preservation procedure and proper soft-tissue healing around a temporary prosthesis, a zirconia cantilevered fixed implant-supported bridge would replace these two teeth. 3.    Processing of Dicom (CBCT exam) and STL (optical impression and digital wax-up) data in coDiagnostiX® planning software in order to carefully plan the implant placement and design surgical guide. 37) and the dedicated BLX® transfer piece drove the implant in the correct position (Fig. She prescribed implant-supported monolithic zirconia restorations on both the mandibular and maxillary arches. 57-58). This allowed us to pre-visualize the final shape of the tooth and to then remove the correct amount of enamel and create the exact space for the ceramic veneer. The overall time of the treatment can be reduced. Within the SAC Classification, this specific case was considered as “complex” (. full zirconia implants available in two parts. 0000022200 00000 n Straumann® Mini Implants. H��W[O\���?�#D���E�,�1vvk��HypV+26рm�q�_�������8M��{}U�뢄A�w�����rz�^���P�)�g�Ϭ���[ܸ��������/�>�>�]�\>�]o���r��?�/6(���%i�'Z�Sm��v&'���fq)⥰�I��&��|�j9�mw������ŗOy��L�/�����%�|�u1��Xe��8���c�8�����y��ZQ��hscA^lo�ӟo�x�yy����5�f�b�[��. Clin Implant Dent Relat Res. When talking about dental implants, missing Straumann can as well be called a blunder. Extraction of the deciduous tooth and orthodontic treatment for the repositioning of the impacted canine in the correct site and the re-alignment of the incisors to improve the smile appearance. ѹ Less plaque attachment on zirconia due to smoother surface compared to titanium. A healthy 30-year-old female patient presented at our dental clinic with the chief complaint of replacing the left upper deciduous canine with a conservative and predictable treatment approach. As we were seeking for the most conservative and efficient approach, our preferable option was to place a post-extractive implant and provisional restoration in the site 23 leaving the permanent impacted canine in its position, as this allows a shorter treatment time and a better patient morbidity and esthetics (Fig. The protocol for this patient considered the placement of a Straumann® BLX® ø4.5mm and 8 mm length in a soft bone, and only 3 drills were required (, It started by using the milling cutter bur in order to create a flat surface for the precise work of the further drills (, In accordance with the choice done during CoDiagnostiX® planning, a BLX® with 4.5mm diameter and 8mm length was selected and placed (, The implant was engaged into the sleeve with the perfect guidance in the prepared bone site (, Despite the reduced amount of available bone, it was possible to reach a 35n/cm torque value for the implant stability and this allowed the placement of an immediate prosthesis (, After the adjustments, the temporary crown was placed in the patient’s mouth (, At the 3- month follow-up visit, the patient presented with an outstanding healing of the soft tissues and referred having no complications within the previous months (, The ideal emerging profile of the temporary crown was therefore ready for the final prosthetic phases involving the implant-supported crown of left canine and the ceramic veneer of right lateral incisor. Fig. The Straumann® Ceramic Healing Abutments offer favorable conditions for soft-tissue attachment, hereby supporting a healthy peri-implant environment. The final decision was to treat the patient with an immediate Straumann® BLX® ø4.5 mm SLActive® 8mm Roxolid® and an immediate prosthesis on position 23, using a computer-guided planning and surgery (coDiagnostiX®) with flapless technique. 42) and the space between the crown and the abutment was filled with resin and then adapted until obtaining a proper emergency profile (Fig. Fig. 0000020827 00000 n Long-term outcomes that meet the highest demands are strongly influenced by components that were designed for a highly esthetic natural look and proper management, health and maintenance of the soft tissues.We have the portfolio that will support you in achieving and … Patient solutions. Meanwhile the ceramic veneer for tooth 12 was also prepared and ready to be cemented. The customized provisional abutment with a diameter of 3,8mm and a gingival height of 1,5mm was screwed on top of the implant (Fig. (�J�2p�mҒ@� �b�} ؄.zC��������(C �L� ���dEA��P+�Χ�{��U����@� �16�@�Cz6$$�-�����ȝi��� One study assessing Straumann ceramic implants in animals found a reduced pocket depth and higher soft tissue attachment compared to an ordinary titanium implant. This represents the plan to be used during implant placement. J!�� S|��4�K��ZX6070>d��p��X��l�Q���2]A� 64). Implant or Abutment Level Abutment Level (8) Implant Level (3) 2: Frontal view of the patient’s smile. Fig.18: Planning the case step-by-step with coDiagnostiX®. A denture set up was fabricated and sent to the doctor for try-in. Fig. TL (Tissue Level) for Narrow Neck CrossFit® (NNC) Implants; for Regular Neck (RN) Implants; for Wide Neck (WN) Implants; for Straumann® Classic; BL / BLT. This was an alternative solution offered to patient. 40). , 03/14 490.028/en/B/001. 38: The dedicated BLX transfer piece drove the implant in the correct position. The first zirconia dental implants were a one-piece design which, although hygienic and good for soft tissue health, meant they could not heal underneath the gums. 26-28). 63). In the intraoral examination, a good amount of keratinized gingiva was observed by the deciduous tooth and a good overall oral hygiene was presented (Fig. In accordance with the choice done during CoDiagnostiX® planning, a BLX® with 4.5mm diameter and 8mm length was selected and placed (Fig. Fig. Fig. The patient and our team were extremely satisfied with the final outcome in terms of health, esthetics and function. 3: Right lateral view of the patient’s smile. 6.    Guided implant placement with a flapless technique and provisional crown positioning. Fig. Zirconia dental implants, also known as ceramic implants are artificial tooth roots made of zirconium dioxide (ZrO₂) that dentists place in your jaw to replace one or more missing teeth.. if you have lost one or a few natural teeth, every dentist will advise you to replace them as soon as possible. 0000269332 00000 n 2-3,8-9. x�b```b``�������� ̀ �@16�.��:�Kw0�nT��"���ӂ*�>G]VW�>��n��X�ct��A�h�ȫS���[كd#O�Q�/���*�L�E��t��X2{� ٛ� 37: The implant ready to be engaged into the sleeve for the perfect guidance in the prepared bone site. Fig. trailer <]>> startxref 0 %%EOF 202 0 obj<>stream prosthetic restorations for Straumann® Bone Level Implants. %PDF-1.4 %���� The analysis of the smile presented the midline sagittal plane coincident with the medium line of smile, and the exposure of the upper incisors and canines was 90% (Fig. 48: Final digital impression: A dedicated scan body was screwed on top of BLX implant and a retraction cord was placed around the tooth 12 in order to highlight the finishing line preparation. 56: Occlusal view of the crown on the model: note the exact positioning of the screw hole due to the precise implant placement with computer-guided surgery. 41: The provisional abutment, shortened and sandblasted by dental lab, was screwed on top of the implant. 45: Post-op X-ray images showing the precision of the placement. Prosthetic Solutions. The mock-up is based on the creation of digital wax-up related to tooth 23 ideal shape for the computer evaluation and to tooth 12 ideal shape for the final veneering. 44: After the refinements, occlusion was checked in the patient’s mouth. 59: Acid-etching of enamel: Note how the adjacent teeth were protected from the injury of the acid. (, 4.    Production of printed surgical guide and resin models via coDiagnostiX® plan (, 5.    Execution of the provisional crown by dental lab on the basis of digital wax-up (on resin printed models) (, The patient underwent local anesthetic infiltration in the area corresponding to the canine apex (, After the extraction, the surgical guide was placed in the patient’s mouth as it is important to verify the stability and the precision of it through the windows created into specific locations (, Following guide placement and verification of the fit, the dedicated set of surgical instruments were ready to use (, As described in the instructions for use, the drilling procedure was carried out until the stop, located on the drill itself. Fig. Auxiliary Parts and Screws RB. (Fig. Fig. Create a new one. systemic conditions, local factors, etc.) x REF. 34). The restorative platform of the implant should be above the gingival crest, and the shortest LoCaToR®abutment providing a margin above the gingival crest should be utilized. Then, the temporary crown was placed into the transparent mask; and after having filled the crown with resin, it was brought in its position by means of the transparent mask for the connection with the provisional abutment. Despite the reduced amount of available bone, it was possible to reach a 35n/cm torque value for the implant stability and this allowed the placement of an immediate prosthesis (Fig. Afterwards, the tooth was conditioned protecting the adjacent teeth and the ceramic veener was cemented using a flowable composite (Fig. Hand … 0000007800 00000 n , A clinical case report by Sergio Piano, Italy. Straumann® implant restorations use state-of-the art CADCAM technology. For this, the tooth 12 was prepared using a silicon mask as a guide: first of all, the initial mock-up was recreated and then the silicon mask (made on top of it) was used to verify the thickness needed for the ceramic veneering (, Afterwards, digital impressions using the Virtuo Vivo™ intraoral scanner were taken, and with this objective a dedicated scan body was screwed on top of BLX® implant and a retraction cord was placed around the tooth 12 in order to mark the line preparation (, Then, the STL files related to the impressions were imported in the Dental Wings lab modeling software. The SAC Assessment tool (based on ITI SAC Classification) can be successfully used for this matter. Zirconia; Literature and Marketing; Implants and Abutments; Refine. Mandibular full-arch restoration with Straumann implant-supported metal mesostructures and zirconia-based prosthesis: a case report. The main objective is to evaluate peri-implant hard and soft tissues's stability with the use of a ceramic implant (Implant Straumann®Pure Ceramic) during one year follow up. Fig. Fig. 14: Digital impressions (DWOS Virtuo Vivo ™) are part of preliminary data acquisition along with intra and extra oral photos and CBCT exam. After a careful examination of the clinical and radiographic findings, we obtained the following treatment options: a. Fig. High-performance Zirconia 13 Institut Straumann AG, Straumann® PURE Ceramic Implants A 100 % proof test ensures reliable implant strength. She also requested to have a temporary fixed rehabilitation during all the phases of the treatment and to improve the esthetics in the frontal area. With the use of this assessment, the clinician can follow a step-by-step online procedure by introducing the data related to the patient (e.g. Straumann recently developed the BLT ∅ 2.9 mm, which has the advantage of being fabricated with Roxolid – a metal alloy composed of 15% zirconium and 85% titanium that has higher tensile and fatique strengths than comparable titanium implants, and has excellent osseointegration and biocompatibility properties. |. 20-21). Kim S, Jung UW, Cho KS, Lee JS. 0000007283 00000 n b. The Straumann® BLX implant made of Roxolid® and coated by a surface of SLActive® in combination with the digital workflow gave us precision and quality results; and allowed us to meet all the patient’s needs by applying an efficient treatment protocol for immediate implant placement and providing an esthetic provisional and final restoration design. 0000010484 00000 n 42: After resin polimerization, the temporary crown was unscrewed. Afterwards, the final crown was carefully polished and adjusted for the placement in the patient’s mouth (Fig. Fig. 40: Despite the reduced amount of available bone, it was possible to reach a 35 n/cm torque value for the implant stability. Fig. 2018 Aug 15. The new smile was harmoniously integrated in the patient’s face (Fig. tӇ��sFB��8���a����{3k�{�t�h�٧��CA�. Being the patient really satisfied, the wax-up related to this dental display will be used for the computer analysis. Health, esthetics and function Intraoral scanner DWOS the ceramic veneer for tooth 12 implant loading to a... Helps surgeons and prosthodontists looking for state-of-the-art products restoring straumann zirconia implants meet the increasing demand esthetic! Strictly followed in order to perfectly stick to the impressions were imported in apical... Intraoral scanner DWOS dentistry and dental tissue regeneration taken in order to perfectly stick to the canine (. 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