Dealing with abutment design errors of an osseointegrated one-piece hybrid root-analogue implant in the esthetic zone
Background: Computer-aided design/Computer-aided manufacturing (CAD/CAM) milled root-analogue implant (RAI) systems can be a great alternative to conventional dental implants if the indication is appropriate. It has been shown that RAIs can reduce resorption processes of bone and soft tissue as a fo...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | Advances in Oral and Maxillofacial Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667147623000079 |
| _version_ | 1797903344827629568 |
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| author | Benedikt Schneider Florian Pfaffeneder-Mantai Oliver Meller Ditjon Bytyqi Maximilian Dobbertin Dritan Turhani |
| author_facet | Benedikt Schneider Florian Pfaffeneder-Mantai Oliver Meller Ditjon Bytyqi Maximilian Dobbertin Dritan Turhani |
| author_sort | Benedikt Schneider |
| collection | DOAJ |
| description | Background: Computer-aided design/Computer-aided manufacturing (CAD/CAM) milled root-analogue implant (RAI) systems can be a great alternative to conventional dental implants if the indication is appropriate. It has been shown that RAIs can reduce resorption processes of bone and soft tissue as a form of immediate implantation. However, such digital workflows can lead to errors resulting from intrinsic and extrinsic factors and can potentially increase with each transition in the digital workflow. Whilst the studies on RAIs have focused on osseointegration and implant success, to date, none of them have addressed the prosthetic abutment design of RAIs. Therefore, this case report highlights the importance of proper abutment design of a RAI and shows how to properly deal with an undersized prosthetic abutment in an already osseointegrated RAI, in the maxillary esthetic zone. Case presentation: We report the case of a 34-year-old female patient who was implanted with a RAI in the maxillary esthetic zone. The tooth 11 was found to not be worthy of preservation and was carefully extracted. Afterwards, a CAD/CAM milled RAI was press-fit placed immediately. After the RAI had healed, the abutment was found to be prosthetically undersized. As a result, the implant could not be directly restored with a conventional crown, as the retention surface was too small to ensure a permanent hold. For this reason, the decision was made to incorporate a retention pin in the definitive crown, which engaged palatially in a retention groove by drilling into the abutment. Thus, a permanent fixation of the final prosthetic restoration was achieved. Conclusions: Appropriate abutment design is crucial for the prosthetic treatment of the RAI, especially in the esthetic zone. In the future, the planning and development of RAIs should focus on the optimal abutment design and the sources of error within the planning and manufacturing process. Finally, the increasing outsourcing of steps within the prosthetic planning can lead to errors and should be taken with great caution. |
| first_indexed | 2024-04-10T09:31:24Z |
| format | Article |
| id | doaj.art-d3880a764f30484395c8b833184921b4 |
| institution | Directory Open Access Journal |
| issn | 2667-1476 |
| language | English |
| last_indexed | 2024-04-10T09:31:24Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Oral and Maxillofacial Surgery |
| spelling | doaj.art-d3880a764f30484395c8b833184921b42023-02-19T04:27:41ZengElsevierAdvances in Oral and Maxillofacial Surgery2667-14762023-03-019100395Dealing with abutment design errors of an osseointegrated one-piece hybrid root-analogue implant in the esthetic zoneBenedikt Schneider0Florian Pfaffeneder-Mantai1Oliver Meller2Ditjon Bytyqi3Maximilian Dobbertin4Dritan Turhani5Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, AustriaCenter for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria; Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, AustriaCenter for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, AustriaCenter for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, AustriaCenter for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria; Private dental office, Eschersheimer Landstraße 34, 60322, Frankfurt am Main, GermanyCenter for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria; Corresponding author. Center for Oral and Maxillofacial Surgery Department of Dentistry, Faculty of Medicine and Dentistry Danube Private University (DPU), Steiner Landstraße 124, A-3500, Krems-Stein, Austria.Background: Computer-aided design/Computer-aided manufacturing (CAD/CAM) milled root-analogue implant (RAI) systems can be a great alternative to conventional dental implants if the indication is appropriate. It has been shown that RAIs can reduce resorption processes of bone and soft tissue as a form of immediate implantation. However, such digital workflows can lead to errors resulting from intrinsic and extrinsic factors and can potentially increase with each transition in the digital workflow. Whilst the studies on RAIs have focused on osseointegration and implant success, to date, none of them have addressed the prosthetic abutment design of RAIs. Therefore, this case report highlights the importance of proper abutment design of a RAI and shows how to properly deal with an undersized prosthetic abutment in an already osseointegrated RAI, in the maxillary esthetic zone. Case presentation: We report the case of a 34-year-old female patient who was implanted with a RAI in the maxillary esthetic zone. The tooth 11 was found to not be worthy of preservation and was carefully extracted. Afterwards, a CAD/CAM milled RAI was press-fit placed immediately. After the RAI had healed, the abutment was found to be prosthetically undersized. As a result, the implant could not be directly restored with a conventional crown, as the retention surface was too small to ensure a permanent hold. For this reason, the decision was made to incorporate a retention pin in the definitive crown, which engaged palatially in a retention groove by drilling into the abutment. Thus, a permanent fixation of the final prosthetic restoration was achieved. Conclusions: Appropriate abutment design is crucial for the prosthetic treatment of the RAI, especially in the esthetic zone. In the future, the planning and development of RAIs should focus on the optimal abutment design and the sources of error within the planning and manufacturing process. Finally, the increasing outsourcing of steps within the prosthetic planning can lead to errors and should be taken with great caution.http://www.sciencedirect.com/science/article/pii/S2667147623000079Immediate placementUpper central incisorCAD/CAMRoot-analogue implantDental implant |
| spellingShingle | Benedikt Schneider Florian Pfaffeneder-Mantai Oliver Meller Ditjon Bytyqi Maximilian Dobbertin Dritan Turhani Dealing with abutment design errors of an osseointegrated one-piece hybrid root-analogue implant in the esthetic zone Advances in Oral and Maxillofacial Surgery Immediate placement Upper central incisor CAD/CAM Root-analogue implant Dental implant |
| title | Dealing with abutment design errors of an osseointegrated one-piece hybrid root-analogue implant in the esthetic zone |
| title_full | Dealing with abutment design errors of an osseointegrated one-piece hybrid root-analogue implant in the esthetic zone |
| title_fullStr | Dealing with abutment design errors of an osseointegrated one-piece hybrid root-analogue implant in the esthetic zone |
| title_full_unstemmed | Dealing with abutment design errors of an osseointegrated one-piece hybrid root-analogue implant in the esthetic zone |
| title_short | Dealing with abutment design errors of an osseointegrated one-piece hybrid root-analogue implant in the esthetic zone |
| title_sort | dealing with abutment design errors of an osseointegrated one piece hybrid root analogue implant in the esthetic zone |
| topic | Immediate placement Upper central incisor CAD/CAM Root-analogue implant Dental implant |
| url | http://www.sciencedirect.com/science/article/pii/S2667147623000079 |
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