Figure 1: Clinical view 6 days after the trauma. |
Figure 2: The implants are more than 4 mm below the gingival level. The gingival emergence profile is increased slightly on the master model. This facilitates the fabrication of temporary restorations with a more harmonious sub- to supra-gingival coronal transition and more suitable dimensions at the gingival 1/3 of crowns 11 and 21. |
Figure 3: After minor gingivoplasty, temporary restorations 11 and 21 are fixed to the implants. They maintain the emergence profile and guide the gingival healing. A porcelain-fused-to-metal restoration 32-X-X-42 is fixed to the implants (Laboratoire dentaire Artech). |
Figure 4: The final shape of abutments 11 and 21 is produced using a Procera CAD 3D program. Each abutment is designed and adjusted labially and interproximally (photo: Mr. Gunnar Bagge, Nobel Biocare, North York, Ontario). |
Figure 5: Procera aluminum oxide ceramic abutments and crown copings (Mr. Paul Hutnik, Quantum Dental Laboratory). The joint use of a ceramic abutment and a ceramic crown improve light transmission. |
Figure 6: Ceramic abutments. The shoulder of the abutment is 1 to 2 mm below the gingival level. |
Figure 7: Tightening of the abutment screw at 32 Ncm with counter-torque. |
Figure 8: Procera crowns cemented with an adhesive composite resin cement (porcelain: Mr. Roger Picard, dental technician). |
Figure 9: Periapical radiographs: a) 11 and 21: implants/posts, b) 11 and 21: implants/abutments ceramic crowns cemented. |
Figure 10: Clinical view 4 years after the trauma to the anterior teeth. |
Figure 11: Root resorption at the level of teeth 21 and 22. |
Figure 12: Aluminum oxide ceramic abutments fixed onto the implants. The shoulder of abutment 21 is at gingival level. |
Figure 13: Procera ceramic crowns cemented (abutments and copings: Mr. Paul Hutnik; porcelain: Laboratoire dentaire Denta-Design). |
Figure 14: Periapical radiographs: Implants 11, 21, 22, screw-retained ceramic abutments (32 Ncm), Procera ceramic crowns. |