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anatomically correct contours (Fig. 27). The abutment is
seated utilizing the jig (Fig. 28) and the screw tightened
to 35 Ncm (Fig. 29). The jig is then removed (Fig. 30). The
crown is seated and the margins and interproximal and
occlusal contacts are checked (Figs. 31a, 31b). Any necessary
adjustments are made. There should be light centric contact
with a firm bite and no lateral contacts. The interproximal
contacts should be light. The abutment screw is tightened
once more to 35 Ncm, and the access opening sealed with
a piece of Teflon tape. The crown is cemented in place
with RelyX Unicem Self-Adhesive Resin Cement (3M ESPE;
St. Paul, Minn.). All excess cement must be meticulously
removed. A PA was taken to verify complete seating and
cement removal (Fig. 32).
Final Delivery:
IPS e.max Screw-Retained Crown
If a screw-retained crown was selected (Figs. 33a–33c), the
one-piece restoration is seated on the implant (Fig. 34). The
abutment screw is tightened to 35 Ncm utilizing the jig
(Fig. 35). The interproximal and occlusal contacts are
checked and adjusted as needed (Fig. 36). The screw access
opening is sealed with a piece of Teflon tape and an occlusal
composite (Fig. 37).
Figure 22: Assembly reseated into impression
Summary
Replacement of missing mandibular molars with singletooth
implant-borne restorations provides many benefits
over fixed partial dentures. It avoids having to prep adjacent
teeth, it makes hygiene easier for the patient, and it allows
for flexure of the mandible. 2 The osteotomy can be created
conventionally or through a guided surgical procedure.
The Inclusive Tooth Replacement Solution provides the
components to simplify the restorative process and provide
a superior final restoration for this common restoration. IM
Figure 23: Soft tissue model
Figures 24a, 24b: Inclusive All-Zirconia Custom Abutment
Figure 21: Custom impression coping mounted on implant analog
Figure 25: Inclusive All-Zirconia Custom Abutment and IPS e.max crown
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