{"id":1823,"date":"2021-09-21T13:01:36","date_gmt":"2021-09-21T11:01:36","guid":{"rendered":"https:\/\/blog.avinent.com\/?p=1823"},"modified":"2024-11-12T12:44:17","modified_gmt":"2024-11-12T11:44:17","slug":"customised-single-unit-restoration-for-an-immediate-post-extraction-iceberg-implant","status":"publish","type":"post","link":"https:\/\/avinent.com\/en\/blog\/customised-single-unit-restoration-for-an-immediate-post-extraction-iceberg-implant\/","title":{"rendered":"Customised single unit restoration for an immediate post-extraction Iceberg implant"},"content":{"rendered":"\n\t\t\t\t\n

Introduction<\/strong><\/p>\n\n\n\n

The geometry of the new Biomimetic Iceberg implant presents the ideal characteristics for designing restorations with implants and prosthetics that observe the biology of the hard and soft tissues, facilitating the aesthetics. The converging shape of the transmucosal part of the neck, with no angles or sharp edges, together with the new line of abutments, provides continuity to the neck of the implant<\/strong> increasing the generation of soft tissue, improving its preservation and achieving the adjustment profile established when planning the case. <\/p>\n\n\n\n

Clinical case<\/strong><\/p>\n\n\n\n

We present\na case of an 87-year-old patient who came to the clinic with pain in the right\ncentral incisor. The examination revealed an unstable crown. Further tests\nconfirmed it was fractured and could not be repaired.<\/p>\n\n\n\n

The\ntreatment plan was decided, consisting of removing tooth 21 and placing an\nAvinent Biomimetic Iceberg immediate-load guided implant with regeneration of\nthe vestibular gap, in conjunction with the placement of a customised\nprovisional abutment with immediate load to stabilise the periimplant tissues\nduring the osseointegration period.<\/p>\n\n\n\n

A plan was\nmade to place an Iceberg implant with a polished collar due to the thickness of\nthe soft tissues that the patient presented. As this case affected an anterior\naesthetic area, the quality of the tissues enabled us to distance the\nimplant-prosthesis union from the bone, decreasing the risk of periimplant bone\nloss, and to model the tissue thanks to the tapered neck of the implant and the\ndesign of this prosthetic line. <\/p>\n\n\n\n

\"\"
Initial images of the case<\/figcaption><\/figure><\/div>\n\n\n\n
\"\"
Initial images of the case <\/figcaption><\/figure><\/div>\n\n\n\n

Surgical and provisionalisation phase<\/strong><\/p>\n\n\n\n

An atraumatic extraction of tooth 21 was performed, respecting the alveolar walls, accompanied by a\nmeticulous curettage of the socket to remove any pathological tissue. <\/p>\n\n\n\n

During the same surgical intervention, a Biomimetic Iceberg implant\nmeasuring 4 x 13 mm was inserted, guided by a splint resting on the teeth and\ndesigned with Implant Studio (3Shape) software.<\/p>\n\n\n\n

  • \"\"
    Planning of the surgery guided by Implant Studio<\/figcaption><\/figure><\/li>
  • \"\"
    Details of the surgical spling<\/figcaption><\/figure><\/li>
  • \"\"
    Details of the surgical spling <\/figcaption><\/figure><\/li><\/ul>\n\n\n\n

    Once the planned 3D position had been achieved, and the primary stability\nof the implant verified, a PEEK antirotation abutment was placed, on which the\neggshell provisional was fitted to shape the desired emergence profile.<\/p>\n\n\n\n

    • \"\"
      PEEK provisional screw-mounted on the implant showing the three-dimensional position<\/figcaption><\/figure><\/li>
    • \"\"
      PEEK provisional screw-mounted on the implant showing the three-dimensional position <\/figcaption><\/figure><\/li><\/ul>\n\n\n\n

      The vestibular gap was filled with particulate biomaterial to avoid the\nreabsorption of the vestibular plate and finally the provisional tooth was\nscrew-mounted at 35 Ncm, and it was confirmed that it remained out of the\nocclusion in maximum intercuspation and the excursive movement.<\/p>\n\n\n\n

      • \"\"
        Preparation of the provisional with the PEEK abutment<\/figcaption><\/figure><\/li>
      • \"\"
        Preparation of the provisional with the PEEK abutment <\/figcaption><\/figure><\/li>
      • \"\"
        Finish of the provisional before placement<\/figcaption><\/figure><\/li>
      • \"\"
        Finish of the provisional before placement guide <\/figcaption><\/figure><\/li>
      • \"\"
        X-ray of the immediate provisional<\/figcaption><\/figure><\/li>
      • \"\"
        Details of the adjustment of the provisional restorarion in the mouth<\/figcaption><\/figure><\/li><\/ul>\n\n\n\n

        Definitive prosthetic phase<\/strong><\/p>\n\n\n\n

        After a\n3-month healing period the provisional restoration was unscrewed and the good\nperiimplant health was verified. The tissues were scanned to transfer the\ninformation on the outline achieved during the provisionalisation period to the\nlaboratory.<\/p>\n\n\n\n

        • \"\"
          State of the tissues 3 months after implant placement and immediate provisionalisation<\/figcaption><\/figure><\/li>
        • \"\"
          State of the tissues 3 months after implant placement and immediate provisionalisation <\/figcaption><\/figure><\/li>
        • \"\"
          Digitally scanned abutment screw-mounted onto the implant and colour test<\/figcaption><\/figure><\/li><\/ul>\n\n\n\n
          • \"\"
            Scanned immediate-load provisional<\/figcaption><\/figure><\/li>
          • \"\"
            Scanned immediate-load provisional <\/figcaption><\/figure><\/li><\/ul>\n\n\n\n

            The definitive restoration on a\ncustomised titanium base where a zirconium crown with a ceramic coating <\/strong>was\ncemented for integration with the adjacent teeth.<\/strong><\/p>\n\n\n\n

            \"\"
            Details of the Zr prosthesis on its customised titanium base<\/figcaption><\/figure><\/div>\n\n\n\n
            \"\"
            X-ray of the excellent tissue outline and stable bone levels<\/figcaption><\/figure><\/div>\n\n\n\n
            • \"\"
              Health of healed periimplant tissues<\/figcaption><\/figure><\/li>
            • \"\"
              Health of healed periimplant tissues <\/figcaption><\/figure><\/li>
            • \"\"
              Image of the definitive restoration in the mouth<\/figcaption><\/figure><\/li><\/ul>\n\n\n\n
              \"\"
              X-ray of the fit of the definitive prosthesis and the maintenance of the periimplant tissues<\/figcaption><\/figure>\n\n\n\n

              Conclusion<\/strong><\/p>\n\n\n\n

              The good planning and execution of\nthe case made it possible to obtain excellent clinical and aesthetic results,\nmaintaining the gingival architecture with an immediate post-extraction implant\nand an immediate-load screw-mounted crown.<\/p>\n\n\n\n

              The design of the Iceberg implant\nenabled the biology of the tissues to be respected. A good thickness of\nkeratinised gum and satisfactory 3D position of the implant led to highly\npleasing results.<\/p>\n\n\n\n

              In this case the expectations of the\npatient were more than fulfilled; the symmetry of lower front teeth was\nimproved, merely by replacing the fractured tooth.<\/p>\n\n\n\n

              • \"\"
                Sequence of views of the final restorarion in the mouth<\/figcaption><\/figure><\/li>
              • \"\"
                Sequence of views of the final restorarion in the mouth <\/figcaption><\/figure><\/li>
              • \"\"
                Front view of the final restoration<\/figcaption><\/figure><\/li>
              • \"\"
                Front view of the final restoration<\/figcaption><\/figure><\/li><\/ul>\n\n\n\n
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                  \t\t\t\tThe geometry of the new Biomimetic Iceberg implant presents the ideal characteristics for designing restorations with implants and prosthetics that observe the biology of the hard and soft tissues, facilitating the aesthetics. \t\t\t\t<\/p>\n","protected":false},"author":2,"featured_media":1785,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[37],"tags":[],"profesional_medics":[114],"segment":[170],"class_list":["post-1823","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-casos-clinicos","profesional_medics-dr-jesus-lopez-vilagran","segments-implantes"],"acf":[],"yoast_head":"\n\u25b7Customised single unit restoration for an immediate post-extraction Iceberg implant - \u3010 Avinent \u3011<\/title>\n<meta name=\"description\" content=\"The geometry of the new Biomimetic Iceberg implant presents the ideal characteristics for designing restorations with implants and prosthetics that observe the biology of the hard and soft tissues, facilitating the aesthetics. \u2713\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u25b7Customised single unit restoration for an immediate post-extraction Iceberg implant - 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