Volume21·Number4
Winter2006·TheJournalofCosmeticDentistry 89
place using Impregum (3M ESPE;
St.Paul,MN).An opposing alginate
impression, photograph, shade, and
impression of the tissue side of the
provisional were taken to provide
the laboratory with the necessary
information to fabricate a final res-
toration. A Procera (NobelBiocare)
restoration was chosen to comply
with the implant manufacturer's
recommendation, and to yield a fi-
nal restoration that would minimize
any dark metal show-through in the
facial gingival area(Fig5).
F
InAl
r
estorAtIon
The provisional restoration was
removed and the final abutment
was manually tightened into place.
The fixture/abutment was cleansed
with a chlorohexidine rinse (Con-
sepsis,Ultradent;SouthJordan,UT)
and the crown was seated. Some
slight interproximal adjustment was
needed to achieve complete seat-
ing.Evaluation of color and contour
showed that the crown was too high
in value and slightly full in the fa-
cial subgingival area, causing some
excessive blanching of the tissue
when seated.
The patient went to the labora-
tory for a custom shade, and so
that the emergence profile could be
adapted for proper tissue support
without excess blanching. After the
color and contour were improved,
the abutment was tightened to 35
Newtonswithatorquewrench,and
the Procera crown was cemented us-
ing Rely Xluting cement (3MESPE).
Photographs were taken at three
months to show the tissue position
(Fig6).
c
Ase
2
Two years after cosmetic enhance-
ment of her maxillary dentition,
this patient fractured endodonti-
cally treated#8 below the gum line
(Figs7&8).It was evident that the
long-term prognosis of#8 was poor
C
liniCal
S
CienCe
e
rlaCh
/J
arviS
Figure 5: Procera crown on analog.
Figure 6: Three months after cementation.
Figure 7: Two years before fracture of #8.
Figure 8: Nonrestorable fracture of #8.