Canada (EN)
CLINICAL CASE
N1™ Base
Anterior case
Dr. Francesco Mintrone
The request of the patient was to replace the fractured tooth and improve her smile, while minimizing the costs. Before starting surgical procedures, we decided to take care of the oral hygiene and periodontal situation. This enabled us to work in a healthy environment at the time of tooth extraction and implant placement. Immediate loading was performed on 21 with a socket shield technique. After the osseointegration of the implant, we decided to proceed with the digital approach to place the final restoration on the implant and a veneer on the other central incisor.
Esthetic analysis
51-year-old female.
Initial clinical situation
Deep fracture of 21 and severe abrasion of 11.
Tooth residue of 21.
Preoperative orthopantomagram. Incongruous fillings on all four maxillary incisors and impacted teeth 18, 38, and 48. Not visible: periapical lesions at tooth 21.
Treatment planing
Evaluation of the case with DTX Studio™ suite software.
Evaluation of the case with DTX Studio™ suite software.
Evaluation of the ideal position of the free gingival margin including crestal bone level assessment.
Evaluation of the socket shield approach to preserve the buccal bone volume.
Surgical guide for the 2 mm drill.
Surgical procedure
Provisional prosthesis and soft tissue healing after 90 days (left).
Peri-apical X-ray where the N1 Base and bone stability are visible (right).
Restorative procedure
Mock-up to evaluate the prosthetic profile of the future rehabilitation.
Minimally invasive preparation of the veneer on 11, and intraoral scanning.
Intraoral scan.
Laboratory procedure
Digital approach.
Digital approach (left).
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP (right).
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP.
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP.
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP.
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP.
Zirconia stamp to simplify the esthetic result.
Double approach with a zirconia stamp plus veneers cemented on top to simplify the esthetic result.
Outcome
Good soft tissue stability around N1 base before the final delivery (left).
Good esthetic integration of the final rehabilitation (right).
Good esthetic integration of the final rehabilitation.
Soft tissue stability (left).
Peri-apical X-ray (right).
Good esthetic integration of the final rehabilitation.
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