Immediate implant placement is considered the treatment of choice for single tooth replacement in the esthetic area. However, this treatment is associated with several critical drawbacks related to the inadequate assessment/management of the soft and hard peri‐implant tissues and their subsequent remodeling, resulting in peri‐implant soft‐tissue defects that can lead to impaired esthetic outcomes in time. We describe in detail how the mucogingival approach to immediate implant placement ensures a standard result regardless of the baseline soft‐hard tissue situation. Fully guided implant placement guarantees an adequate three‐dimensional implant placement, the flap design makes it possible to perform bone augmentation with complete visibility of the area being treated, allows soft tissue augmentation with proper fixation of the connective tissue graft, and the placement of an immediate provisional ensures stabilization of the peri‐implant tissues throughout the healing period.
Additive Manufacturing (AM) brings ground-breaking opportunities to provide customized healthcare solutions with reasonable time and cost. These benefits become more evident if reducing the distance between the printing process and surgery. In this direction, the Arburg Plastic Freeforming (APF) process offers unprecedented opportunities. The absence of hazardous feedstock materials such as powders allows for the utilization of this technology within hospitals. Also, unlike traditional AM processes, APF makes it possible to process medically approved standard granulates without compromising their certification. In this study, APF has been used to manufacture, for the first time, a patient-specific cranial implant (PSCI) using a biocompatible polymer with a high energy absorption capability, namely, PolyCarbonate Urethane (PCU). The main technological issue was represented by the lack of a solvable support material compatible with PCU. This obstacle was overcome by a custom support structure made of the same material, which can be removed at the end of the process with limited damage to the PSCI. The orientation of the part within the building chamber was chosen to optimize the accuracy of critical features and the surface quality of the regions facing the brain. The 3D-printed cranial implant showed high toughness during mechanical impact tests.
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