Loose Lips Sink Ships: Smile Design, CEREC Guide, Legacy 4 Anterior

Here is a cool case. Was hoping for immediate temporization but ended up using a flipper due to lack of stability. Patient fractured #9, some weirdness with insurance so we ended up ordering a flipper (in retrospect, good move) and planned on EXT and Graft, but ended up going for the immediate. Placed old crown back and just scanned the model, using a little inlay to push it into the SSI

 

 

Extracted what was left, made sure the buccal plate was intact and sized up a medium reference body for CEREC guide.

 

Using CEREC 4.3 and Smile Design, I really wanted to get a feel for the patient’s lip line and it was nice and low in case we got any recession.  This is such a cool and underused tool when generating an SSI to put in to Galileos.

 

Got to be honest, wish I had a 16mm implant on hand, just had a 13, but planned it anyway, note the intact buccal plate and implant emerging from the cingulum.

 

 

CEREC guide ready to roll!! Set the D2  a little longer, at 25. Use the drill extender to get some length.  Love using the drill to assess angulation and depth.

 

 

Placed a 3.7 by 13mm Legacy 4.  Didn’t have the torque I wanted, so we ended up grafting, placing a collagen membrane and just using the flipper, will start tissue forming at 3 months.  Overall an OK case!

 

 

Ok about 4 months later, I was beta testing the new CEREC version and had to free some space, ended up losing my RST file for this one, so no CEREC screen shots!  Lasered a gingival profile and made a temp in telio CAD.

 

 

Used the same file for the final, did a lot of post try in contouring.  Telio does such a good job of forming the tissue.

Here is the final, make sure you use enough teflon tape to opaque out the access. The end result is OK, I’m a little low in value.