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Chairside Real-time Implant Temporary Restoration

Overview

Aesthetic design of front teeth and shape retaining of alevolar crest are two tough issues for front teeth implant. To retain the shape of alevolar crest, patients should wear the restoration on time after implant surgery so as to prevent atrophy or deformation of alevolar crest. In this case, SHINING 3D Aoralscan, Einscan, and EXOCAD smile design module are used for aesthetic design of front teeth.

Solutions

Case Introduction

Gender: Female
Age: 48
Chief Complaint: Front tooth fracture for one week
Diagnosis: Root fracture of tooth 11
Treatment: Extraction # 11 root, and perform real-time implant and resin crown restoration

Preoperative Examination

CBCT is performed before surgery. The results show that the bone mass of tooth #11 is enough, but the thickness of labial bone wall is fewer than 1mm. Therefore the “shield”method is adopted to keep part of the labial tissue so as to prevent the collapse of the labial bone wall.

Implant Surgery

Prepare the cavity for implant. Place in the Osstem 3.5×15mm TSIII  impant. The implant position is accurate, and the implant is stability at early stage.

“Shield” Method

Keep gingiva tissue for about 1mm thick at labial side, and the “shield”is formed.

Implant Bone Meal

Implant bone meal in the labial“jumping gap”

Surgery Completion

Try in the healing abutment for further temporary crown preparation

Postoperative Examination

CBCT is performed after surgery to check the location of the implant

Preparation before Intraoral Scan

Scan Body Disinfection/Sterilization

Before intraoral scan, soak the scan body in disinfection fluid for 5 minutes. Then put it in a sterilized vacuum bag. Put the bag in the sterilization cabinet for sterilization at 121℃ and 1.5 atm for 15 minutes.

Scan Body Try-in

Put the sterilized scan body in the patient’s mouth and make sure that it is correctly and completely located. X-ray examination can be used when necessary. 

Intraoral Scan

Use Shining3D Aoralscan to obtain the intraoral data of the patient. The scanning process takes about 7 minutes

Face Photo Taking

Take pictures of patient’s face for further smile design and case record.

Face Scan

Use Shining 3D Einscan to collect the face data of the patient.

Import Intraoral Data into Exocad for Design

Import the intraoral order into Exocad, and check the job definition.

CAD Design of Temporary Crown

Use the Exocad smile design module to design the temporary crown restoration of tooth 11 and gingiva contact as required.

CAD design of temporary crown

Design an aesthetically satisfactory restoration based on the face scanned data.

Design Completion

The CAD design of temporary crown restoration  is completed.

CNC Milling

Import the milling data into milling software for milling. The milling takes about 20 minutes.

Milling Completion

Resin crown milling is completed. Stick the base into the resin crown, and an implant temporary crown is formed.

Try-in

Try the temporary abutment and resin crown in the patient’s mouth. The X-ray examination result indicates correct crown location, suitable abutment, and slightly contacted occlusion. During the period of temporary resin crown, gingiva is remodeled for further restoration.

Conclusion

“Shield”method was applied to retain part of gingiva tissue at labial side and prevent collapse of bone wall.

Smile design makes aesthetic design of front teeth. The combination of SHINING 3D Aoralscan, Einscan, and exocad smile design module enables us to perform aesthetic design based on the patient’s current teeth.

With this digital procedure, patients can wear the temporary restoration on the same day of clinical implant, which is helpful for gingiva remodeling for further restoration.

Aoralscan Advantages

Powderless. Better operation experiences.

Realistic color. Improved design experience and case preview effect.

Cost effective. Professional and strong support team.

High accuracy. Accurate details and data.

Easy operation. Easy to assemble and disassemble .

Intelligent scan. Convenient pre-design tools.

Doctor Introduction

Chen Qingsheng

Associate chief physician. Master’s degree in implant dentistry. Director of the implant department in Hangzhou Dental Hospital (Chengxi branch). Member of Chinese Stomatological Association Restoration Committee, Chinese Stomatological Association Aesthetic Restoration Committee. Standing director of Chinese Association of Aesthetic Dentistry. Prize winners of various national implant competition.

Doctor’s  Comments

“Aoralscan is accurate, fast, efficient. With it the doctor can accurately acquire the intraoral information. Satisfactory restoration can be made with the use of equipped professional software for design and milling machine. This digital procedure reduces the chairside operation time and provides patients better experience. Hope it can be widely used.”