CATEGORY AUSTRALASIAN DENTIST 55 corresponding teeth to give her an impression of the expected treatment and, at the same time, obtain her consent (Fig. 3). u Afterwards, surgery was simulated virtually (not shown in the images), and the virtual construction was designed in the CAD planning software (Implant Studio, 3Shape), maintaining the alveolar architecture. The surgical template was additively manufactured from a suitable printing resin (Cosmos SG, Yller) on a 3D printer (Photon Mono 4K printer, Anycubic). A minimally traumatic extraction was performed on the incisor 21, attempting to preserve the integrity of the gingivae, the papillae and the gingival architecture as much as possible (Figs. 4 and 5). u The implant surgical guide (Fig. 6) was then placed in position, and the implant (Grand Morse Helix Acqua 3.75×13 mm, Neodent, Straumann) was screwed using an 800-rpm drilling sequence and abundant irrigation (Fig. 7). The fresh type 1 extraction socket quickly showed some gingival collapse (Fig. 8). A gingival former (Grand Morse Healing Abutment, Neodent, Straumann) was temporarily then screwed onto the implant. To treat adjacent maxillary gingival recessions, a Modified Coronally Advanced Tunnel technique (MCATtechnique) was used (not pictured). To support fast revascularisation and soft-tissue integration, including colour and texture, a type I and III collagen matrix derived from porcine dermis (Mucoderm, Straumann) was used (Fig. 9) as an alternative to autologous soft tissue transplantation. u At the same time, bone regeneration was performed using a natural bovine bone substitute material (0.5–1.0 mm bone granules, Cerabone, Straumann). u Later, the gingival former was removed and a scanning abutment (Grand Morse 3‑in‑1 Smart Abutment, Neodent, Straumann) was placed to scan the final implant position and soft tissues. This information was transferred to the CAD/CAM design software (exocad, Align Technology), Fig. 01 Tomographic section of tooth 21 featured altered corono-radicular and a pronounced bone concavity in the vestibular apical region. Fig. 04 Minimally traumatic tooth extraction. Fig. 07 Implant placement. Fig. 02 The challenge is to transfer the shape, texture and colour of tooth 11 to the restoration in region 21. Fig. 05 Fresh type 1 extraction socket. Fig. 08 The fresh type 1 extraction socket quickly showed some gingival collapse. Fig. 03 Simulation of the approximate final result (Mock-up from Structur CAD, VOCO). Fig. 06 3D-printed implant surgical guide. Fig. 09 For the enlargement of the vestibular gingival volume, a collagen matrix from porcine dermis was inserted. Fig. 10 Hybrid abutment. The milled aesthetic substructure from highly filled nano-hybrid composite (Grandio disc, VOCO) is adhesively cemented on the scanning abutment (luting material: Bifix Hybrid Abutment, VOCO). Fig. 11 The aesthetic substructure serves as the base for manual layering with nano-hybrid ORMOCER composite (Admira Fusion, VOCO). To guarantee adequate space for all layers, the substructure presents a small cutback. Figs. 12 to 14 Preparation for the layering of composite veneer under absolute isolation with a rubber dam. CLINICAL
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