The Cervico system on adjacent molars.
Two adjacent implants in this case.
Customised Cervico healers, simplified contemporary approaches and one surgery to place the implants, augment the hard tissues and redesign the peri-implant soft tissues.
No barrier membranes, no soft tissue grafting.
Initial and final situation.
Customised Cervico healers were used to redesign the peri-implant soft tissues and manage the emergence profile, without the use of soft tissues grafts.
The initial pilot trephinations were done in a flapless manner using the appropriate Cervico tabs as a surgical stent.
The Cervico pins were installed to verify the correct positioning and orientation.
Subsequently, a full-thickness flap was raised, the implant bed preparations were completed and the implants (Keystone Paltop Dynamic implants in this case) were placed.
The difficult question is how deep to seat the implants.
Many different factors to consider, but we know that the biological width will need 3.5-4 mm so that all zones of the implant supra-crestal complex will be formed properly.
Therefore, I use the Cervico depth gauge to measure the depth of placement and the thickness of the overlying soft tissues, and I adjust the depth of placement in order to have 4 mm in total.
The next step is to identify for each implant the ideal anatomy of the cervical margin of the future crown (using the Cervico anatomical tabs) and using the appropriate well of the Cervico mold I fabricated the customised healing abutments.
The customised Cervico healers fitted and the area was augmented as usual using a b-TCP/Calcium sulfate biomaterial, according to published protocols.
No barrier membranes used.
The flap was positioned buccally to the implants with small Palacci incisions and sutured with SKD high-quality monofilament 5-0.
The prosthetic canal of the healing abutments was sealed with anti-bacterial SilverPlug, instead of PTFE.
Bluem oxygen-releasing gel as a disinfectant agent and to promote the healing of the soft tissues around the Cervico healers.
Two weeks post-op.
Excellent healing.
No signs of inflammation and no plaque accumulation on the sutures.
Again bluem gel as we need the active oxygen during the healing period
The healing 3 months post-op.
No need for any additional procedures.
Now that we have generated the correct emergence profile, we can transfer all the information to the lab, to create restorations that comply with all functional, biological, and aesthetic requirements.
Exceptional work by Phill Reddington at Beever Dental Laboratory.
Clinical view and pa x-ray immediately after fitting the screw-retained crowns.
Both crowns look short as the upper teeth have over-erupted during the long period of the patient's edentulism.
The customised Cervico healers not only act as a prosthetic sealer for the underlying bone graft but also help to redesign and augment the soft tissues and establish a proper emergence profile.