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    How to do same-day implant restoration

    A technique showcasing how the millable VITA ENAMIC IS block enables same-day results.

    Prior to the advent of CAD/CAM dentistry, restoring implants using the analog method required PVS impressions and multiple appointments. In the first appointment, a traditional impression was taken and sent to the lab for fabrication of the implant restoration. Several weeks later, the patient presented for the seating of the restoration.

    CAD/CAM dentistry allowed dentists to image the implant digitally and eliminate PVS impressions. It also enabled us to design and fabricate the restoration, as opposed to sending it to a lab, giving the dentist the ultimate control over emergence and tissue pressure. Using this method, the final restoration can be delivered approximately two and a half hours following imaging, or in a subsequent appointment.

    Related reading: I Use That: VITA ENAMIC IS

    ENAMIC Implant Solutions (IS) significantly reduces the processing time because it does not need to be fired in the oven. Additionally, the resiliency of the material potentially minimizes forces to the abutment screw and the crestal bone. The case below illustrates the efficiency of using ENAMIC IS to restore an implant in a little over an hour.

    Armamentarium

    • Chairside CAD/CAM system
    • Scan post and scan body to image the implant platform, angulation and timing into the CAD/CAM system.
    • TiBase specific to the implant connection and platform diameter.
    • VITA ENAMIC IS size 16 or 14 L or S, depending on the type of restoration and implant type.
    • Multilink hybrid abutment cement to join the abutment to the TiBase.
    • Hydrofluoric acid for etching
    • Silane for intaglio surface of restoration
    • VITA Easyshade® V
    • ENAMIC Stain Kit
    • Curing light

    Patient presentation

    The patient, a healthy 38-year-old male with an unremarkable medical history, presented with a non-restorable tooth #19.

    The tooth had a vertical root fracture and recurrent decay. The patient was given an option for an implant at site #19 or a fixed bridge from teeth #18-20. The patient elected to have the tooth extracted and an implant placed immediately at the time of extraction. The implant placement was planned using a CBCT scan and Galaxis software.
    The clinical crown was sectioned off and the initial osteotomy was performed through the furcation of the tooth to keep the implant centered. The roots of #19 were then removed atraumatically, and the osteotomy was completed.

    A 5x10 mm Implant Direct Interactive implant was placed and torqued to 40 Ncm. The site was grafted with a cortico-cancellous mix of DFDBA bone and sutures were placed. The site was allowed to heal for three months, at which time the patient returned for his final restoration.

    Continue to page two to read more...

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