All-ceramic crowns on modified CeraOne abutments: a case report

Area of Science:

• Dental Implantology
• Prosthodontics
• Biomaterials

Background:

• Congenitally absent maxillary lateral incisors present unique restorative challenges.
• Significant alveolar process inclination can lead to severe discrepancies between implant and crown axes.
• Aesthetic rehabilitation requires careful planning to avoid compromised screw access or labial overcontouring.

Observation:

• A 17-year-old patient with congenitally missing maxillary lateral incisors required single-tooth implants.
• The alveolar bone presented a pronounced inclination, creating an axis mismatch for the planned implant and final crown.
• Standard prosthetic components could not adequately address the angulation issue without aesthetic compromise.

Findings:

• A CeraOne abutment (Brånemark System) was selectively ground in a dental laboratory to modify its angulation.
• This modification facilitated proper alignment of the implant and the restorative crown.
• Individual all-ceramic crowns were fabricated using the Celay In-Ceram system, integrating seamlessly with the modified abutment.

Implications:

• Modified abutments offer a viable solution for managing complex implant angulation challenges in challenging anatomical situations.
• This technique allows for the fabrication of aesthetically superior, screw-retained restorations without compromising the screw channel or requiring excessive labial tooth structure.
• The successful use of modified abutments and all-ceramic crowns highlights a patient-specific approach to achieving optimal functional and esthetic outcomes in implant dentistry.