Abstract Title

Anterior Maxillary Immediate Implant Placement and Straumann Angled Solutions Restoration

Lead Author Affiliation

Doctor of Dental Surgery

Lead Author Status

DDS Year 3

Expected Graduation Date

2019

Presentation Category

Implant Dentistry

Introduction/Context/Diagnosis

This is a clinical case demonstrating placement of an immediate dental implant following the extraction of #7, a necrotic tooth with external resorption. The implant procedure was completed in two stages, then restored with an angled screw-retained Straumann crown. This crown is a new option offered by Straumann which tilts the screw channel up to thirty degrees, where otherwise a cement-retained crown would be the only esthetic and functional option.

Methods/Treatment Plan

First step for this procedure was an implant consultation followed by a CBCT and virtual implant placement. Atraumatic extraction of #7 performed prior to 3.3x12 mm Straumann implant placement. Cover screw placed followed by buccal allograft bone graft, collagen membrane, and cytoplast membrane. Essex retainer with 1mm clearance delivered following procedure. Osseointegration check and stage II completed 6 months later. Temporary abutment fabricated chairside was placed after osseointegration to create adequate contour for emergence profile. Closed tray final impression was taken one month later, as patient and team were happy with gingival contour. Final restoration was the Straumann Variobase Angled Solutions crown to allow for a lingual access in a screw-retained crown.

Results/Outcome

Immediate implant placement with delayed loading and bone graft with double membrane technique allowed for successful osseointegration of implant. Temporary abutment was successful in generating papilla around temporary crown with no black triangles. Layered Zirconia Straumann Angled Solutions crown was both esthetic and functional, revealing healthy pink gingiva and pockets of 1-3 mm surrounding implant at 1 week follow up. As for future improvement, I would recommend that students refrain from placing the impression coping into the closed tray impression themselves. My crown was delivered slightly off angle, and whether it was my placement that was off or an alteration during the fabrication process, ultimately the dental provider is liable for the outcome. However, the crown was able to be adjusted chair side, allowing for an outcome that satisfied the patient's esthetic needs.

Significance/Conclusions

This case was the first at our school in which an angled screw-retained Straumann crown was able to be delivered. By incorporating this design into the treatment plan, we were able to avoid using cement and allow for retrievability in the future. My intention is that students become familiar with this option and consider it in their future treatment plans for patients.

Comments/Acknowledgements

Oral Surgeon: Dr. Boghossian

Implant Restorative Faculty: Dr. Shaw and Dr. Gonzalez

Format

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Anterior Maxillary Immediate Implant Placement and Straumann Angled Solutions Restoration

This is a clinical case demonstrating placement of an immediate dental implant following the extraction of #7, a necrotic tooth with external resorption. The implant procedure was completed in two stages, then restored with an angled screw-retained Straumann crown. This crown is a new option offered by Straumann which tilts the screw channel up to thirty degrees, where otherwise a cement-retained crown would be the only esthetic and functional option.