CAMLOG Speical Issue Treatment Planning

Case Report 12 | 2011 Fig. 7: The fixtures are connected to the temporary abut- ments. The provisionals are relined using an index matrix in the predetermined position using the dia- gnostic wax-up. Fig. 8: Implants in place and provisional restorations repo- sitioned without functional loading. Fig. 9: T en weeks postoperatively. The soft tissues are con- ditioned with the help of the provisional restorations to generate scalloped contours. Healing with provisionals Fig. 1: Clinical view before starting orthodontic treatment. Fig. 3: I nitial phase of the orthodontic treatment to create space for the implants. Note the shifting of the incisor roots and the remodeling of the periodontal support. Fig. 4: P re-surgical viewwith the root axes relocated mesially. Pre-surgical orthodontic phase Fig. 6: I mplants in place and flaps sutured. Fig. 5: C linical evaluation of the mesiodistal space. Implant placement The 24-year-old female patient presented with congenitally missing lateral incisors, that had previously been orthodontically treated for a Class II mal- occlusion. The first examination revealed an inverse position between the upper right canine and first premolar. Additionally, there was a root conver- gence preventing implant placement in the lateral incisor sites. Minor orthodontic treatment was necessary to create the space for implant placement. Once the fixtures were inserted and the temporary abutments connected to the implants, the provisionals were relined using an index matrix Information on patient and treatment taken from the wax-up. From the diagnostic wax-up, it was decided that, in order to attain a satisfying final esthetic outcome, it was necessary to also restore the distal aspect of the central incisors and the right first premolar for anatomical and functional reasons. Finally, after having screwed the abutments on the implants, inducing a torque of 20 Ncm, the metal-ceramic restorations were cemented with temporary cement. The patient was re- called at two, four and 12 weeks for check-ups and every four months for professional hygiene. Fig. 2: Wax-up to anatomically plan the case. A wax-up is the quickest and most reliable guide for determining the necessary space.