The instalment of Straumann® implants and the fabrication of metal-ceramic screw-retained implant crowns

Our foreign female patient aged 54 reported to our clinic in June 2017 for an inspection. Based on the examination of the oral cavity and the panoramic radiograph recorded at our clinic one dental focus was diagnosed. The inflammation having formed on the apex of the root canal treated and crowned tooth (chronicus periapicalis periodontitis) indicated the extraction of the tooth.

The panoramic radiograph recorded on 09. 06. 2017 clearly indicates the inflammatory lesion having developed around the root canal of the lower left molar no. 6.

The lower left first molar (no. 36) was extracted on 04.07.2017. Following consultation with the patient our choice on a Straumann® implant for the replacement of the missing tooth. For the secure retention of the implant 3 months’ healing time is required. 4 months later the patient returned for implant surgery. The procedure is carried out in local anaesthesia or conscious sedation, if required. With latter method the patient remembers nothing whatsoever about the interventions, which is why it is particularly recommended if the patient is apprehensive of dental interventions (dental phobia).

The implant surgery was performed on 28. 11. 2017.

Encircled, the X-ray scan shows the implant installed in place of tooth no. 36

Once the implant is installed a minimum of 3 months is required before the finished permanent crown can be installed for the implant to firmly integrate into the neighbouring bone mass (osseointegration).

Our patient was able to pay her next visit to Hungary in 2018, which is when the permanent implant crown was finished. Implant retained crowns can be secured on the implant in two different ways, either means of a screw or cement. The screw-retained solution has the benefit that in the event of issues with crown or the implant such as the ceramic chipping off, discoloration, etc., the crown section can easily be removed by loosening the screw and can even be screwed back on, whereas a cement-retained crown cannot be removed non-destructively, only by cutting off the crown which necessitates the fabrication of a new crown.

When fabricating a restoration precision impressions are taken of the jaws. Casting the gypsum mould is followed by bite registration using an Artex face bow and the selection of the appropriate tooth colour. Based on this information the dental technician can prepare the permanent restoration.

The permanent screw-retained implant crown on the master cast and in the mouth

Once the screw-retained implant crown is secured the screw thread is covered with a tooth-coloured white filling

The screw thread is covered with a filling for aesthetic considerations

The implant with the screw-retained crown installed into the position of tooth no. 36