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The Single Implant-Crown Complex in the Aesthetic Zone: Abutment Selection and the Treatment Sequencing

  • Stavros PelekanosEmail author
Chapter

Abstract

It is a great challenge for the clinician to choose a methodology, abutment design, and type of restoration in order to achieve optimal results and avoid complications in implant rehabilitations in the aesthetic zone. The great variety of materials that are coming in contact with the soft tissues (acrylic, base alloy, gold, titanium, zirconia, and recently lithium disilicate) further complicate the decision-making, and as they show different soft tissue response and color, they seem to affect the final result, especially in patients with thin biotype.

This chapter will focus on the methodology of the prosthetically driven single implant placement, especially in demanding aesthetic cases, on today’s knowledge of the biology of different materials and abutment selection (customized vs. prefabricated abutments, screw vs cement retained) and provide some clinical guidelines to achieve optimum aesthetic results. Finally, new approaches regarding “immediate abutment placement,” “intermediate abutment placement,” and digital technology for impression in combination with prefabricated CAD lithium disilicate blocks will be discussed with the help of clinical case presentations.

Keywords

Single implant Timing of implant and abutment placement Abutment selection Metal abutment Ceramic abutment Platform switching Screw-retained crown Cement-retained crown Cement-screw-retained crown Intermediate abutment Digital workflow 

Supplementary material

Video 18.1

Video showing the correct implant positioning according to the guide stent (MP4 90210 kb)

Video 18.2

Video showing how to customize the impression coping according to the emergence profile (MP4 60816 kb)

Video 18.3

Video showing the customization of the emergence profile of a single implant in the lab (MP4 4651 kb)

Video 18.4

Video showing the digital design of a customized zirconia abutment for a cemented restoration (MP4 60634 kb)

Video 18.5

Video showing the customization of the emergence profile, zirconia abutment, and provisional crown fabrication prior to extraction and implant placement on a stereolithographic model (MP4 30447 kb)

Video 18.6

Video showing tooth extraction and implant placement with the use of a stereolithographic stent. “One time-final abutment” and provisional crown insertion (MP4 67100 kb)

Video 18.7

Video showing the customization of the healing abutment. The concave shape of the abutment does not exceed the dimensions of the extraction socket, thus protecting the blood clot and leaving space for the soft tissue to grow (MP4 26866 kb)

Video 18.8

Video showing only one disconnection of the final abutment and extraoral cementation of the final crown (MP4 51248 kb)

Video 18.9

Video showing the correction of the screw access with the use of The LTS abutment (MP4 4330 kb)

Video 18.10

Video showing the extraoral cementation of the veneer on the lithium disilicate implant abutment (MP4 23058 kb)

Video 18.11

Video showing the final cement-screw-retained crown insertion (MP4 27524 kb)

Video 18.12

Video showing a double digital impression of the implant and the achieved emergence profile (MP4 92854 kb)

Video 18.13

Video showing the digital design of a LS2 abutment to fit in the customized emergence profile (MP4 64681 kb)

Video 18.14

Video showing the milling of the abutment from a pre-crystalized lithium disilicate block (IPS e.max CAD) with a pre-manufactured connection (MP4 40149 kb)

Video 18.15

Video showing the laboratory procedure for the cementation of LS2 abutment on the titanium sleeve (MP4 120876 kb)

Video 18.16

Video showing the insertion of the final lithium disilicate abutment and cementation of the final e.max crown (MP4 47041 kb)

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Prosthodontics, Dental School of AthensUniversity of AthensAthensGreece

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