For definitive restoration fabrication, a scan body was placed and an intraoral scan performed. A virtual model was created and several definitive restoration scenarios pursued. A custom abutment and crown were designed (Figure 11) and abutment milled from a PreFAB-4 blank in the DS1300. A monolithic zirconia crown (NexxZr®T, Sagemax, www.sagemax-dental.com) was milled and differentially shaded to an A3.5 shade. A lithium disilicate (IPS e.max®, Ivoclar Vivadent, www.ivoclarvivadent.com) crown was also milled simultaneously with the custom titanium abutment in the DS1300 system (Figure 12).
On delivery, the custom abutment was seated and ceramic crowns tried in; proximal contacts and occlusion were checked. The crowns were polished with either the Dialite® ZR or Dialite® LD system (Brasseler USA, www.brasselerusa.com). The zirconia crown was selected and cemented with SpeedCEM (Ivoclar Vivadent) on the custom abutment in the laboratory. The retrievable abutment crown was seated on the implant, the abutment screw torqued to the appropriate level, and screw access hole filled with PTFE tape and composite resin (Figure 13 and Figure 14).
All of the components necessary for a completely digital workflow have finally come together. The transformative technology of a compact desktop wet milling machine combined with the semi-prefabricated titanium milling blank enable the dental clinic or dental lab* to perform same-day milling of an implant abutment, ceramic crown, or hybrid ceramic crown. Intraoral scanning devices, design software developments, and integration of all the components in the process bring dentistry to a new age in digital implant prosthodontics. Equally encouraging is that these technologies are highly affordable and give the practice or lab* the freedom and control to produce cost-effective custom abutments yet still deliver high precision without compromise.
The authors have no relevant financial interests to disclose.
Thanks to Dr. Michael Yeh of Federal Way, Washington, for his outstanding surgical implant placement.
Dentists may use this system to mill implant abutments for their own clinical use. Dental laboratories wishing to produce and market 510k-cleared custom implant abutments with this system can do so when following appropriate procedures. Contact Biodenta for additional details.
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