case_images: PMC3870648_01
case_images: Initial radiograph of maxillary left central incisor.
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case_images: fig1
case_images: The radiographic examination showed an oversized cast post and core, which occupied three quarters of the root's length (Figure 1).
case_images: The maxillary left central incisor with a metal ceramic restoration. Its margins were placed on the underlying cast post and core.
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case_images: fig2
case_images: The clinical examination revealed that the metal ceramic restoration was fractured at the buccal marginal area, it had a surface texture that did not match that of the adjacent natural teeth, it was rather opaque, and its margins were placed on the underlying cast post and core instead of on sound tooth structure (Figure 2).
case_images: Atraumatic extraction of the maxillary left central incisor.
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case_images: fig3
case_images: An atraumatic tooth extraction was then performed with the use of a periotome, taking extra care to preserve the buccal plate (Figure 3).
case_images: Placement of an Osseotite NT implant in the extraction socket. The platform of the implant was placed 2 mm apically to the cementoenamel junction of the right maxillary central incisor.
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case_images: fig4
case_images: The platform of the implant was placed 2 mm apically to the cementoenamel junction of the right maxillary central incisor (Figure 4).
case_images: Buccal bone deficiency filled with bovine bone material.
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case_images: fig5
case_images: A bone deficiency remained buccally and it was filled with bovine bone mineral (Bio-Oss Collagen, Geistlich) (Figure 5).
case_images: Initial provisional PMMA acrylic resin crown.
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case_images: fig6
case_images: The sutures were removed after 10 days (Figure 6).
case_images: The impression coping was modified with light-polymerizing resin material to register the peri-implant soft tissues.
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case_images: fig7
case_images: Light-polymerizing resin material (Liquidam; Discus Dental, Culver City, CA) was injected around the impression coping and was immediately polymerized with a UV polymerizing unit, preventing the soft tissues from collapsing onto the impression coping (Figure 7).
case_images: The impression coping into the polyether impression material used. Note the amount of light-polymerizing resin material added to support the soft tissues.
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case_images: fig8
case_images: A plastic stock tray and polyether material (Impregum, 3M/ESPE, Seefeld, Germany) were then used for the impression (Figure 8).
case_images: A new provisional crown was fabricated with light-polymerizing resin, in order to better support the soft tissue contours mesially and provide a better esthetic result.
case_images: CRIM.DENTISTRY2013-378062.009.jpg
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case_images: fig9
case_images: Tokyo, Japan) (Figure 9). This provisional restoration was fabricated in order to support better the soft tissue contours mesially and provide a better esthetic result (Figure 10).
case_images: Clinical view of the new provisional crown.
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case_images: fig10
case_images: Tokyo, Japan) (Figure 9). This provisional restoration was fabricated in order to support better the soft tissue contours mesially and provide a better esthetic result (Figure 10).
case_images: A definitive screw retained metal ceramic restoration was fabricated 6 months after implant placement.
case_images: CRIM.DENTISTRY2013-378062.011.jpg
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case_images: fig11
case_images: Porcelain was applied and baked in the traditional manner (Figure 11).
case_images: Final radiograph obtained at 6 months after implant placement.
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case_images: fig12
case_images: After the delivery of the definitive restoration (Figures 12 and 13), the patient was followed every 4 months for the next year.
case_images: Clinical photograph of the definitive metal ceramic crown.
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case_images: fig13
case_images: After the delivery of the definitive restoration (Figures 12 and 13), the patient was followed every 4 months for the next year.