Case report: A 60 year old female was referred to the clinic due to crown fracture of the central incisor tooth 21. It had previously been treated with apical surgery and a temporary composite build-up by the referring dentist. The patient requested an immediate smile solution if possible, where the Immediate Smile featuring ATLANTIS Abutment solution was chosen. An ASTRA TECH OsseoSpeed TX implant in combination with ATLANTIS initial and final abutments were used for achieving immediate excellent esthetics.

Procedure - Incision in region 22 - Flap Design - Preparation of the Implant Bed - Implant Placement - Suture - Extraction of tooth 12 - Curretage - Implant Placement Materials Implant System: 3I, Osseotite, Ø 4mm Region 12: 15mm length Region 22: 13mm length

Contents: - Considerations for prosthetic treatment planning (PowerPoint) - Production of the drill guide according to prosthetic specifications (PowerPoint) - Surgical procedure (film) - Flapless surgery - Access preparation - Pilot drilling using the drill guide - Preparation of the implant site - Internal sinus lift - Implantation Materials Checklist: Pilot drill; Alignment pin, depth gauge Straight osteotome for bone condensation (Ø 3.5 mm); Larger drills to enlarge the osteotmy; Round burs; Osteotome, angled, for sinus lift (Ø 4.2 mm); Ratchet, adaptor for ratchet (short); Holding key for transmission, SCS screwdriver (short); STRAUMANN Standard Plus RN implant (Ø 4.1 mm, L: 12 mm) and healing abutment (2 mm); STRAUMANN Standard Plus WN implant (Ø 4.8 mm, length 12 mm) and healing abutment (3 mm); Scalpel blade (15c) and scalpel blade holder (Martin); Two dental mirrors and dental forceps; Surgical forceps; Anatomical forceps; Probe; Periodontal probe; Sharp spoon; Sterile compresses (Hu Friedy); Isotonic sodium chloride solution, 0.9% (Braun).

Outline - Modified tubed flap - NobelActive implant placement - Flapless facial bone augmentation - Immediate provisionalization Materials Checklist: NobelActive™ Surgery Kit Twist drill ø 2, 7-15 mm Twist drill ø 2, 10-18 mm Twist step drill ø 2.4/2.8, 7-15 mm Twist step drill ø 2.4/2.8, 10-18 mm Twist step drill ø 3.2/3.6, 7-15 mm Twist step drill ø 3.2/3.6, 10-18 mm Surgical driver NobelActive™ Man torque wrench, surgical NobelActive™ Internal RP implant Procera® esthetic abutment, NobelActive™ Internal Implant replica, NobelActive™ Internal RP Impression coping, open tray, NobelActive™ Internal RP Protect analog, NobelActive™ Internal.

Contents: - Surgical procedures for anchoring a diagnostic guide - Inserting four provisional implants - Impression and bite registration, fabrication of the master cast - Tooth-setup for the temporary restoration - Registering the setup in a silicone index - Duplicating the setup in radiopaque resin for CT imaging - Implant planning using a 3D record of the CT image - Fabricating a transfer template based on the CAD treatment plan using the CAMLOG® Guide System - Inserting the guiding sleeves into the template - Fabricating the final restoration prior to inserting the implants - Vario SR abutments with Vario SR titanium copings for a passive fit - Fabricating a cast titanium framework to reinforce the restoration - Surgical procedures demonstrating the definitive implant insertion - Insertion of six implants for immediate loading - Providing a controlled-clearance fit between the implants and the denture base

Contents: - Patient presentation and esthetic analysis - Careful extraction of a non-salvageable tooth - Miniplast splint as a surgical template - Harvesting bone from the implant bed - Placing a CONELOG® implant at site 11 - Obtaining a corticospongeous bone cylinder at site 48 - Alveolar augmentation and reconstruction of the buccal bone lamella - Harvesting a connective-tissue graft - Tunneling the vestibular mucosa, various suturing techniques - Insertion of the provisional restorations - 3 months later: Preparing, impression and arbitrary transfer with a bite fork and facebow, temporary restoration - Master cast, new wax-up, determine the emergence profile - Fabricating a hybrid abutment, Scanning the custom abutment, on-screen crown design - Fabricating a zirconia abutment and a feldspathic ceramic veneer - Conditioning and adhesive attachment of the components, final intraoral check - Try in and adhesive cementation

Outline: - Patient presentation, impression, comprehensive jaw relation records - Wax-up, Fabrication of the provisional restoration - Fabrication of a DVT based planning and drilling template - Surgical procedures for inserting four implants in the mandible - Suturing and relining of the existing denture as a provisional restoration - After 12 weeks: Reentry and insertion of healing abutments - Harvesting a free gingiva graft to extend the attached gingiva - Verifying implant stability using Periotest - Reworking the existing denture to fit on the healing abutments - Impressioning with custom tray (pick-up technique) - Demonstrating the line finder to transfer face axis - Fabricating the three restorations with Locator® attachments, electroplated double crown, precision-milled bar - The matrix and retention parts of the Locator® system, transferring the Locator® abutments to the implants - Fabricating the electroplated copings, intraoral adhesively connecting the electroplated copings to the cast framework (passive fit), finishing and delivery - Removable restoration on a custom-milled bar, clinical and laboratory workflow, delivery - Maintaining implant-supported restorations

Outline: - Incision - Flap mobilization - Lateral sinus fenestration - Elevation of the Schneiderian membrane - Implant bed preparation - Bone chip harvesting at the mandibular angle - Filling of sinus lift lumen with autologous bone chips - Implant insertion - Covering the lateral sinus cavity with collagen membrane - Wound closure List of materials - Zeiss Pro Dent microscope with beam splitter and Panasonic 3 CCD camera - Scalpel holder (Ustomed) with Swann-Morton blades 15C and 12D - Narrow rasp (Hu-Friedy) - Micro-vacuum (Luer Lock Suction Tip, American Dental Systems) - Disposable vacuum tube set (Bexamed) - Disposable draping, Lindau (Aescologic) - Piezosurgery with diamond ball (Mectron) - Microforceps (Hu-Friedy) - Excavator (Martin) - Periodontometer, 1-mm gradation (Hu-Friedy) - OsseoSpeed implant set, Dentsply Implants: Marking drill; Twist drill, 2 mm; Depth gauge; Pilot drill, 2/3.2 mm; Twist drill, 3.2 mm; Tapered drill, 3.2/5 mm; OsseoSpeed TX implant, 5.0 × 11 mm; Closure screw, 4.5/5 mm - Columbia curette (Ustomed) - Micross scraper (Meta) - Needle holder (Ustomed) - Langenbeck wound retractor (Ustomed) - Kelly scissors (Ustomed) - Buchanan endodontic hand plugger (American Dental Systems) - Resorbable collagen membrane (Resodont, Resorba) - Ethilon 5-0 FS-3 (Ethicon) - Prolene 6-0 DA-2 (Ethicon)