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18 CASE STUDY CONCLUSION Fitting the final restoration Before fitting the hybrid abutment crowns, the healing caps were removed (Fig. 29) and the implant bases were detached for the first time [3]. Figure 30 shows the slight bleeding in the soft tissues, caused by the loosening of the collagen fibres attached to the abutment. This image reveals the good seal to the peri-implant hard and soft tissues by the stable gingival cuff and the adhesion of the fibres to the abutment [5]. We rinsed the implant interface with a chlorhexidine solution, inserted the hybrid abutment crowns, and screwed them into the implant with 20 Ncm (Fig. 31) . We prefer directly screw-retained construc- tions. They are easily and quickly inserted and there is no need to remove cement ex- cess from the sulcus. Cement residue that is not removed may trigger peri-implant disease [7, 8]. We checked the occlusion and re-tightened the abutment screws with 20 Ncm after another five minutes. We sealed the screw access channels first with temporary plastic, took a X-ray to check the exact fit of the reconstruction, and then checked the lateral occlusion (Fig. 32 and 33) . Four months after fitting the two hybrid abutment crowns, the peri-implant conditions were stable for the standardized implant restoration in the lower jaw (Fig. 34) . The demographic shift will continue to change the requirements for dental care. Implant-supported restorations are one of the common and trusted treatment options. Their high stability and good bone integration means that implants enable the application of fixed therapeutic concepts that usually result in a better qualityof life for patients. However, patients cannot or do not want to invest so much money the care of their teeth. It is up to the treating dentist to select a suitable therapy on the basis of discussions with the patient, the findings, and the diagnoses, taking into consideration the appropriate procedure, time, and cost/benefit factors. For this reason, we offer simple standard- ized implant concepts for the non-esthetic zone. The standardized iSy Treatment Concept reduces both the surgical effort and the number of sittings with the patient. The components included in the implant set, such as the healing caps, multifunction caps, and the form drill, mean that the management of orders and parts that would otherwise be necessary is omitted. The concentration on a few work steps, the reduced drilling protocol, and the transgingival healing reduce the costs. With the help of this elegant, transgingival implant concept, we leave the implant base in situ until the final abutment is fitted. This appears to favor the preservation of soft and hard tissues and to make our results more predictable and more stable than was previously possible. New and cost- effective biocompatible materials that can be precisely prepared using CAD/CAM technology are gaining in importance. The hybrid abutment crowns are screwed on in the mouth immediately after removal of the implant bases. This means that other- wise necessary measures to cement the crowns to the abutments with subsequent removal of any excess cement from the sulcus are no longer required. If the resto- ra-tion is extended, the abutment crowns can be simply removed and the implant can be easily integrated into a bridge restoration. Fig. 29: To fit the hybrid abutment crowns, the healing caps were removed. Fig. 30: For the first time after the surgical procedure the implant bases were removed. The loosening of the bonded collagen for fibers caused slight bleeding. Fig. 31: The hybrid abutment crowns were inserted and the screws were tightened with 20 Ncm. The screw access channels contained in the zirconia can be easily seen.