2-visit tooth replacement- from extraction to final CAD-CAM crown. 3-year follow up.

149 Rating(s).

Posted on By Anton Andrews In Digital Scanning & CAD/CAM

Proof-of-concept for complete dental implant treatment in ONLY TWO visits.
1st visit : #4 extraction>immediate implant placement>3d Scan>GBR

in between:Delayed CAD utilizing Andrews RRR (reversed restorative Rehabilitation protocol)
CAM for Screw-retained FCZ crown

2nd visit - 5 months after the surgery: implant uncovery>buccal flap re-positioning with frenulum attachment>delivery of 100% digitally made crown. 1C1T one crown one time.

Initial situation
Scan was obtained on immediately placed implant

CAD for Andrews RRR
8 weeks after delivery

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Anton. Nice work! Early delivery " one everything one time" is an excellent approach so long as the initial design and fabrication is ideal. Thank you for sharing. Best regards. Chuck


Thank you Charles.
Unfortunately this concept won't work with referrals.


Do you find there are more adjustments to the crown to be made as proximal and opposing teeth might migrate or extrude during the healing period? Also, how do you determine where the gingival margin level will be to start the sub gingival concavity ?


Laurent ,
the adjustments for this case did not exceed those usually done for regular case.
BTW, the crown has about 7 degree divergence with the axis of the implant, nevertheless it was possible to use screw-retained concept.
With RRR I am able to design just after taking a quick look at the healed site.
But for less advanced operators a ST scan might help.


I like the 1C1T concept as it follows our 1A1T concept from 2001. Very similar only the next step and evolution. I would suggest you take a look at the Ritter Implant system which seems to follow your philosophy, they call it the CIR (Complete Implant Restoration) System. Includes implant, parts, scan body, final abutment and crown. We are moving towards the restoration and not just the implant any longer. well done

Spiral Implant
Scan body day of placement


Hi Anton,

I'll take you up on the offer. I have started designing my own crowns, next step is implant crowns.
BTW, it was great to meet you in San Diego at IADI symposium.



Thanks Peter,
it was a pleasure to meet you too.
I see that you liked my lecture.
I think you will enjoy the "creation" process as I do ,once you'll pass the learning curve.


thanks for the comment,
Yes 1C1T is the logical sequel to yours 1A1T ,
When RRR is used 1C1T is a positive side effect of this protocol.

regarding ritter, I am aware about their approach, but there are few cons :
1. I do not like the hydrophobic surface of ritter implants.
2. They charge $595 for the "all parts" but in my case I spend $150-200 on an implant and $120 on lab and components.
3. They give a "free trios scanner" if a dentist does 15 implants/month.
with this volume , in my case, it will be a TRUE FREE scanner, software and all licences in less than a year!
4.Moreover, I will never trust a lab tech to design my restorations.
it took 6 minutes to design This case .
I estimated that 99.99% of dental techs are not able properly design a simple case like that.
5. I can teach ANY DENTIST to be able to design an implant crown in less than 10 minutes.


Great approach Anton! As usual your CAD-Cam procedures are surprisingly efficient! Thanks for posting.
I like it.


Thank you Jorge,
You are right
CAD-CAM opens new frontier for dental practitioners


Very interesting approach.Result is nice and time spent on case very good.
Are you confident on wide appplication of this method?
Aren't you afraid about variation on volume?, unless you take a second superimpsed impression on the first one and include the volume variation on the final impression design.
Great to show this cases and good discussion opportunity.


Armando, thanks for the compliment ,
Actually I utilize RRR 2-visit treatment protocol in 95% of my cases.
You are absolutely right about ST scan superimposed over the scan bodies in order to update the soft tissue contours especially on grafted cases.


1-year follow up on #2VisitToothReplacement protocol. Stable Soft tissue, papillae and bone levels are evident on #4

1-year follow up
1-year follow up


3-year post op


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