Libros

The purpose of this case series was to assess the application of a novel self-cutting, tapered implant (Straumann® BLX, Institut Straumann AG, Basel, Switzerland) in combination with a digital integrated prosthetic workflow for the immediate placement and restoration. Fourteen consecutive patients, requiring replacement of a single hopeless maxillary or mandibular tooth, meeting the clinical and radiographic indication criteria for immediate implant placement, were treated. All cases followed the same digitally-guided procedure of extraction and immediate implant placement. Immediate temporization with full contoured screw-retained provisionals was performed using an integrated digital workflow. After implant placement and dual-zone bone and soft tissue augmentation, connecting geometries and emergence profiles were finalized. The average implant insertion torque was 53.2 ± 14.9 Ncm and ranged between 35 and 80 Ncm, allowing immediate provisional restoration in all cases. Final restorations were delivered three months after implant placement. An implant survival rate of 100% was observed at the 1-year recall after loading. The results of this case series suggest that immediate placement of novel tapered implants and immediate provisionalization using an integrated digital workflow can result in predictable functional and esthetic results for the immediate transition of failing single teeth in the esthetic area.

Purpose: The purpose of this article is to propose a new protocol for the accurate transfer of the peri-implant soft tissue emergence profile (EP) using a customized healing abutment or a provisional restoration whose shape is integrated into prosthetic design software. Report: The EP of the future restoration is created extraorally with an ideally shaped customized healing abutment or a provisional crown. Before insertion, the latter is screwed into a repositionable analog placed on a specially designed device and scanned with an intraoral scanner (IOS). This repositionable analog (Straumann RB Repositionable Implant Analog, Art. no. 065.0023), whose original purpose is to keep the correct orientation of the implant platform when placed in a printed model, is already available on the market. It is an exact replica of the implant with a corresponding external index. When scanned, it allows the digital transfer of the exact implant position and index. After healing, a full-mouth impression is made with an IOS without removing the customized healing abutment or provisional restoration. The STL files issued from both impressions are merged to produce a digital model used to design the final restoration, which can be inserted at the next appointment. Conclusion: The technique described is simple, predictable, and precise. It does not require a traditional implant level impression or the use of a digital accessory such as a scanbody to transfer the 3D implant position and the peri-implant gingival contour. Palabras clave: dental implants, esthetic zone, immediate placement