| Background: Dental implants,known as "a third set of teeth of human",can restore missing teeth with many advantages including improved esthetics,comfortable feeling,better stability and improved chewing ability.Compared with the traditional denture,dental implants can protect remaining natural teeth from being prepared which is required for fixed bridge denture and avoid instable and uncomfortable defect like removable dentures.Dental implants have become the preferred treatment for missing teeth due to ability of no damaging existing teeth and are choice of more and more patients.However,with the continuous improvement of living standards and the maturity of implant technology,only restoring the morphology and function of missing tooth cannot meet the demands of the patients,it is key how to improve aesthetics effect of implants with chewing function like nature tooth.The most widely practiced method of placing dental implants is a "staged surgery" procedure,including burying the implant,placing abutment after implant osseointegration to form a cuff or collar of gum around the abutment then placing the prosthetic tooth.Stock-manufactured abutment can often result in unaesthetic issues such as black triangle of gum,revealing internal metal color.With the improvement of technology and materials to meet requirement of patient,all-ceramic abutment especially customized implant abutment become popular.CAD/CAM(Computer Aided Design/Computer Aided Manufacturing)customized abutment could form precise fit with patient conditions and be designed according to the three-dimensional space of missing tooth.The upper structure of the implant can restore optional contact with remaining nature tooth.CAD/CAM customized abutment provide a base for denture plasticity and aesthetic predictability.Objective: To evaluate aesthetic effects and advantages in red and white aesthetics using CAD/CAM customized abutment in delayed or immediate implant for missing teeth,summarize the advantages and disadvantages of customized abutment in clinical practice and applications,and provide cases and reference data for wide use.Materials and Methods: xxx dental implant patients after year 2014 were chosen from Beijing Camry Dental Center.The delayed or immediate resin prosthetic were fixed on implants using screw without occlusion contact after placing implants,which were modified according to oral condition after surgery.Customized impression,shape of gum cuff and transgingival height were obtained for processing customized abutment and crown when osseointegration and remodeling of soft tissues finish after postoperative 4-6 months.The prosthetic crown were placed on customized abutment using screw,then screw holes were filled with resin and polished.Results: 32 implants achieved good osseointegration without pathological bone resorption after six months or more follow-up.The treatment using customized abutment plus all-ceramic prosthetic gain satisfactory except for one case due to poor bone and soft tissue conditions in implant area.Conclusion: The implant therapy using customized abutment plus all-ceramic prosthetic can get better aesthetic and functional effects in suitable patients.Despite the use of customized abutments,poor conditions in bone and soft tissue in implant area can affect implant restoration effects to a certain extent affected. |
PDF Full Text Request