RESTORATIVE TREATMENT
After 12 weeks, successful osseointegration was verified. The Encode Healing Abutment was removed and the definitive Encode Abutment was placed into the internal interface of the implant. A Gold-Tite® Hexed Abutment Screw was placed to secure the abutment to the implant and the screw tightness was verified at 20Ncm with a Restorative Torque Indicator. An intraoral radiograph was taken to verify complete seating of the abutment (Figure 6) and a laboratory processed provisional crown was tried in. The occlusion was verified and the provisional crown was cemented. The patient was given instructions for proper self care and discharged.
Three months post-placement of the Encode Abutment and provisional crown, the patient was seen for placement of the definitive PFM crown. The definitive crown was fabricated from a duplicated abutment following the clinician’s original laboratory protocol. There was no need for an additional impression to be made because the facial gingival margins had remained stable after implant placement. An intraoral radiograph was taken that verified crown adaptation to the abutment and the patient was discharged with instructions for proper self care (Figures 7 and 8).
CLINICAL OVERVIEW
In this case, atraumatic removal of the failed maxillary right first bicuspid, was followed by grafting of the extraction site and healing for four months. An Encode® Healing Abutment was placed at the time of implant placement. The minimal surgical approach (single-stage, flapless protocol) minimized soft-tissue changes. The restorative protocol followed in this case saved chairtime and generated minimal post operative discomfort. From a biological point of view, placement of the Certain® PREVAIL® (internally interfaced) Implant and Encode Healing Abutment facilitated maximum preservation of the crestal and facial bone, as well as the interproximal papillae. It has been demonstrated in the dental literature1 that multiple abutment connections and disconnections can trigger inflammation and bone resorption.
1. Abrahamsson I, Berglundh T, Linde J. The mucosal barrier following abutment dis/reconnection. An experimental study in dogs. J Clin Periodontol 1997;24(8):568-572.
