CAMLOG Speical Issue Treatment Planning

Initial situation Fig. 33: Pre-surgical view. Final restoration Fig. 35: Final restoration at three-year follow-up. Fig. 34: R adiograph taken in the initial phase of the ortho- dontic treatment. Fig. 36: R adiographic outcome at eight-year follow-up. Conclusions This article presents a systematic approach for restoring anterior teeth in the es- thetic zone usinga diagnostic additivewax-upandan interdisciplinary approach to optimize the final esthetic outcome. The case is a typical example of a previ- ous orthodontic treatment, that did not address all existing problems with an in- terdisciplinary approach. The patient needed to be retreated, and communica- tion and coordination among the operators were key factors for a satisfying esthetic result. Coordinated treatment by the orthodontist, periodontist, prost- hodontist, and dental technician, with careful consideration of patient expecta- tions and requests, were critical for the successful outcome and patient satisfac- tion. Comfort and esthetic outcome were ensured by a specially developed strategy to redefine an adequate smile line, that wouldmatch the unique and in- dividual character and personality of the patient. Based on the current concepts of implant prosthodontics, it is no longer suffici- ent to merely attach a prosthetic device to an underlying fixture. In fact, it has become essential to reconstruct the site with a three-dimensional approach, where the soft-tissue profile plays a crucial esthetic role. This approach invaria- bly involves hard-tissue regeneration, which allows implant placement in the desired position, as determined by the restoration. The soft-tissue profiles are in turn generated by the actual form and contours of the prosthesis. With the im- pression technique presented here (Figs. 13 – 18) it is possible to preserve the transmucosal profile previously obtained and increase the stability of the trans- fer copings during the removal of the impression from themouth. Moreover, the microhorizontal rotation of the transfer copings, when the laboratory implant analogs are screwed into the transfer copings, is bypassed, and the implant mas- ter cast is more accurate.