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Fig 2a: CEREC scan post Fig 2b: Digital designing Fig 2c: Digital model

Fig 3a: Ti-Base Sirona meso block of A1 shade Fig 3b: Abutment with crown

captured using the CEREC workflow and the Primescan oral scanner.
(Figures 2a, 2b, 2c)
For the prosthesis, implant scan bodies and a screw-retained
crown using the Zimmer TSX implant on a Ti-base were fabricated
with a Sirona meso block in A1 shade using the Primemill machine.
Sintering of the meso block was completed in the SpeedFire furnace.
The crown was cemented extraorally onto the Ti-base with dual-cure
resin cement (Ivoclar MultiLink). During the try-in, occlusion and
proximal contacts were carefully verified.
The patient was highly satisfied with the final outcome and was
scheduled for a six-month follow-up, which showed stable hard and
Fig 4: Final Chairside functional crown
soft tissues surrounding the implant. An IOPA X-ray confirmed that
timed over a Ti-base extraorally. both the implant and the prosthesis were in ideal 3D positioning,
ensuring a positive prognosis. (Figures 3a, 3b, 4, 5a, 5b)
CASE REPORT
A 45-year-old male patient presented to the clinic with the chief DISCUSSION
complaint of a fractured tooth in the upper front region, seeking Advancements in the implant surface technology have allowed for
an aesthetic restoration and an early treatment option. Based on the reduction of treatment durations, including the adoption of early
radiographic and clinical data, a single trabecular implant with early loading protocols following implant placement. Evidence suggests
[7]
loading and chairside crown placement on a Ti-base was planned, that the implant placements can now be completed using early
considering the patient’s anatomical structure and intermaxillary loading protocols to shorten the overall restoration period. With the
relationship. increasing demand for faster and more efficient treatments, the concept
The treatment plan was explained to the patient, with an emphasis of implant insertion combined with immediate provisionalization
on the importance of alveolar bone preservation for the success of early has garnered significant attention. Immediate implant placement
[8]
implant loading. The root stump of tooth number 22 was extracted offers patients several advantages, including fewer interventions and
under local anesthesia, followed by the immediate freehand placement a shorter overall treatment time. However, such approaches should
[9]
of a Zimmer TSX implant. Excellent primary stability was achieved only be recommended if the survival rates and risks of biological and
with an insertion torque exceeding 40 NCM, and ISQ measurements aesthetic complications are comparable to those of conventional,
were recorded at 80. A healing abutment was then placed. (Figures 1a, sequential procedures.
1b, 1c, 1d) Achieving adequate primary stability is critical for the success of
The patient returned 15 days later for the chairside prosthetic early implant placement protocols. Strong mechanical retention of the
procedures. A follow-up ISQ test indicated excellent early secondary implant within the host bone is necessary to prevent micromovements,
stability, with a reading of approximately 84. A post-operative OPG which could compromise osseointegration. Immediate restoration
[10]
was taken to verify the implant positioning. Digital impressions were supports soft tissue and optimizes peri-implant soft tissue aesthetics,
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Dental Practice I July-August 2024 I Vol 20 No 4 51