Casework Study: Restoring Implants #8, #9 with Procera

Restoring a case with implants in the #8 and #9 positions can prove to be a challenging clinical situation.  A well functioning and esthetically pleasing result is crucial to the success of such a case.  If the dental implant placement is less than ideal, which can sometimes happen, restoring the implant can be especially difficult.

An excellent option in such a situation is the custom abutment, and when esthetic demands are particularly high (such as with the #8 and #9 positions) a zirconia abutment and zirconia crown deliver an exceptional solution. Custom abutments also make the case easier for the restorative doctor because the abutments can be designed on the master cast to achieve ideal shape, contour, emergence profiles, and margin depths- tasks that can prove to be difficult in the mouth.   

Restoration of an implant using a custom abutment is one of the easiest ways for a dentist to restore an implant case.  The dentist simply needs to impression the implants as they would in a crown and bridge case (following implant manufacturer’s protocol) and send the impression to the lab.  At that point the dental lab technician pours the master cast, designs the abutment, and scans it for milling. 

When the abutment returns to the lab, the technician will then scan the abutment and design copings for milling.  The milled zirconia copings are built up with porcelain, stained and glazed, and then finished for return to the office.  At the seat appointment the doctor seats the abutments and torques them into place. 

The finished crowns are then seated over the abutments for a highly functional and esthetically pleasing result. 

Here is a two unit (#8, #9) implant case restored with Procera custom zirconia abutments and Procera zirconia crowns:

1. The lab receives the impression.  Impression copings and implant analogs are placed in the impression.
2. The master cast is poured and mounted with pink tissue at the sites of the implants
3. The technician waxes up an anatomically “ideal” abutment.
4. The Procera Forte scans the wax-up for milling of the zirconia abutment and the coping.
5. Milled zirconia abutments achieve excellent esthetics and allow for adequate porcelain build-up.
6. Scanning of the abutment for designing copings for crowns.
7. Procera zirconia copings ready for porcelain build-up.
8. Final restoration ready for the seat appointment.

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