A 22-year old female patient suffered aplasia of both lateral maxillar incisors. After orthodontic treatment, the local dentist filled the intermediate spaces in regions 12 and 22 with two Implants. The patient came to our clinic with advanced peri-implantitis on the implant in region 22 (Figs. 1, 2). An impression was taken of the maxilla and mandible. Then a removable single tooth clamp temporary prosthesis was fabricated pre-operatively, supported occlusally on the neighbouring teeth. This was to fill the space that arose after explantation of the implant.
PRODUCT INFORMATION BY THE MANUFACTURER
The Straumann® PURE Ceramic Implant is the result of more than 9 years of research and development. It has a natural looking ivory color, a feature that makes the implant look more like a natural tooth and supports the clinician in cases of thin gingiva biotype or soft tissue recession. Its monotype design is based on features of the Straumann® Soft Tissue Level Standard Plus and Straumann® Bone Level Implants. According to a survey (data on file), patients would prefer tooth-colored implants, if given the choice between ceramic and metal implants. With the Straumann® PURE Ceramic Implant, clinicians can offer their patients a natural and highly esthetic solution, benefitting from favorable soft tissue attachment around zirconia implants.
To form the gingival soft tissue, a single temporary tooth restoration was fabricated from composite on a Straumann temporary coping. Optimal soft tissue formation was then ensured using a CAD long-term temporary restoration (Fig. 7). After approx. 16 weeks, the final impression was taken for a full ceramic crown (Fig. 8). The postoperative X-ray shows the correction positioning of the implant in the maxilla bone (Fig. 9)
It was possible to treat the highly esthetically challenging situation with limited space and significant bone deficit well using a gradual treatment concept. The choice of a reduced-diameter 3.3 mm Straumann one-piece ceramic implant with macro- and micro-rough surface and optimal biocompatibility ensured not only treatment success but also met the desire of the patient for a tooth-colored, completely metal-free solution, with a dark titanium implant showing through the gingiva on the opposite side. The measures for GBR were consistent with the usual approach for titanium implants.
The treatment described in this article was performed with substantial contributions from Dr. Michael Gahlert, Munich (Germany) and Dr. Stefan Röhling, Basel (Switzerland).