Replacing A Lateral Incisor Using SMART Base
Volume 4 - Issue 3
Massa L1* and Fraunhofer JAV2
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- 1Premier Dental Centers, USA
- 2School of Dentistry, University of Maryland, USA
*Corresponding author:
Massa L, Premier Dental Centers, USA
Received: March 12, 2020; Published: March 16, 2020
DOI: 10.32474/MADOHC.2020.04.000188
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Abstract
Replacing a missing lateral incisor always presents a dentist
with various challenges, notably the need to ensure an esthetic
result and long-term clinical viability in restoring oral health
and functionality. Due to concavities in the premaxilla region the
implant apex is often placed with a cant to the palate. This dilemma
can be solved with custom abutments which increase the cost of the
case. The SMART base allows up to 25 degrees of angle correction
which allows for screw retention in these cases (Figure 1). Figure 2
shows a radiograph of a missing lateral incisor and a pre-operative
template of a wax-up. An implant is then placed in the jaw and
allowed to heal for 6-8 weeks to ensure osseointegration (Figure
3). Thereafter, a temporary abutment is placed, adjusted and after
the screw is removed, a cotton pellet is placed to close the aperture
and protect the abutment threads (Figure 4). The temporary
abutment is then “picked-up” using a flowable composite while an
emergence profile and screw access is created with the composite
resin (Figure 5). The temporary restoration is then placed, and the
retaining screw torqued to 15Ncm (Figure 6). Thereafter, the screw
access is closed with a cotton pellet and composite resin (Figure
7). The SMART base can then be scanned (Figures 8) and digitized.
The final screw-retained zirconia restoration can then be fabricated
using CAD/CAM technology and placed in the mouth (Figure 9).
The final result is shown in Figure 10.
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