A Novel Technique for Immediate Loading Single Root Form Implants With an Interim CAD/CAM Milled Screw-Retained Crown

Abstract

A technique is described where an interim abutment and crown are fabricated in the laboratory by utilizing computer-aided design/computer-aided manufacturing (CAD/CAM) technology and placed the day of dental implant surgery. The design and contours of the interim crown are designed by the computer software to be identical to the contours of the tentatively designed definitive prosthesis. The interim crown satisfies esthetics immediately after dental implant surgery while allowing the tissue to heal and obtain contours similar to the contours of the definitive prosthesis. The interim crown can be either cement retained or screw retained. The presented technique describes fabrication of a screw-retentive interim crown. After osseointegration is confirmed, a definitive impression is made with a CAD/CAM impression coping. The definitive prosthesis is then fabricated.

Use of Implant‐Supported Custom Milled Impression Copings to Capture Soft‐Tissue Contours and Incisal Guidance

“…The significance of the described technique is that a CMIC was used to transfer the contours of the digitally designed and clinically verified multiunit SRIP to the definitive prosthesis. Custom impression coping milled from a PMMA block has been introduced in the literature for single implant‐supported crowns . The described technique offers a suggestion for implementing digital technology in designing and milling a CMIC for an ISFP.…”

“…The described technique offers a suggestion for implementing digital technology in designing and milling a CMIC for an ISFP. In addition, in previous publications, the CMIC was designed and milled based on ideal, digitally designed contours of a tentatively designed definitive prosthesis . Intraoral modifications of the interim prosthesis were not considered when the CMIC was designed, neither were they considered when the definitive prosthesis was designed.…”

“…The degree of soft tissue shrinkage is unknown before a digital intraoral impression can be completed. A CMIC might be effective in supporting soft tissue profile, preventing shrinkage of the soft tissue . A clinical study is needed to validate a potential advantage of using a custom milled titanium impression coping.…”

“…Interim implant‐supported prostheses are important in verifying esthetics, contours, and occlusion that can then be used as a guide in developing the definitive prosthesis . In addition, the peri‐implant and edentulous soft tissue architecture can be affected by the design and contours of the interim restoration .…”

“…Various methods have been suggested to transfer the soft tissue contours to the laboratory. Use of the interim prosthesis as a custom impression coping, intraoral fabrication of a custom impression coping, implementation of digital impression technology, or fabrication of milled impression copings are some of the suggested techniques . Joda reported that soft tissue tends to collapse after the interim prosthesis is removed.…”