2-Visit Replacement Protocol. RRR. DENTOLOGY Digital workflow. Part 2.

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The small flap that you push out towards buccal, is this contained by the concavity in the crown? Cause there are no sutures right??

Thanks

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Also, you wouldn't use a full zirconia crown for a front tooth between noon restored natural teeth right?

You would rather have your layers of ceramic to enhance aesthetics and mimic natural teeth?

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Hi Anton. Great case! Thank you for part 2. I have a few questions:
1) What degree (literally) of deviation from "straight line of draw" is obtainable with this system and how does this 2 piece system differ from a cement or bonded screw retained hybrid?
2) What do you believe the nature of the "'rolled tissue" to be at the time of restoration and does it changes over time?
3) Did you to expose and examine the shield at the time of restoration? Do you feel shield exposure (or not) will impact tissue healing different between implant and restoration?
A lot to figure out. Best regards. Chuck

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Hi Charles, thanks for compliments,
see the nanswers below
1) What degree (literally) of deviation from "straight line of draw" is obtainable with this system
15 degrees is the maximum but it depends on the length of the crown. I usually do not need to use more than 10.
and how does this 2 piece system differ from a cement or bonded screw retained hybrid?
it is a hybrid FCZ on the ti-base, bonded outside the mouth. Cement free technique prevents from complications .
2) What do you believe the nature of the "'rolled tissue" to be at the time of restoration and does it changes over time?
I had extra tissue so I did a roll, I could be punched and the effect could be the same. Roll suppose to thicken the CT .
What do you think? Roll vs punch?
3) Did you to expose and examine the shield at the time of restoration? Yes I had and it was fine
Do you feel shield exposure (or not) will impact tissue healing different between implant and restoration?
2-visit concept features "all - one time" so this is the least invasive compared to everything else.

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Anton. Thank you for yours answers. In regard to exposure of the shield during to roll process, I am interested in knowing wether or not there was enough time lapse to permit bone apposition (if possible) adjacent to the shield. IMO 1A1T shouldn't apply at the shield interphase. Ideally we should perpendicular (not circular)orientation of fiber attachment. BTW I would expect the tissue roll in conjunction with SS to be more effective long term. Try to observe to difference of your shield vs non shield cases over time. Especially if you need to replace crowns at some point. Best regards. Chuck

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Charles, I sounded bone with a probe around the implant and it was hard all 360.
In this case there was 1-2mm gap between the implant and the shield.
I noticed more buccal bone retained over time with shields vs fully extracted teeth
Regards,
Anton

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Thank Andoni,
to answer your questions, there were no sutures placed in this case, the restoration acts as a "prosthetic plug" sealing the site.
Regarding anterior cases, where aesthetics is demanding, the porcelain layering is possible since its very easy to do cutback in CAD/CAM. With Zirconia getting better these days, it will be obsolete soon.

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Hi Anton! I have few questions:
1. I know most of the dentist when they placing implants aim that access hole would be in central groove, some asking buccal cusp. In your case it is palatal, Why?
2. Do you like the lip of the restoration?
3. Do you think placing implant more buccaly would improve the design? Gregory

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Gregory, thank you for great questions!
One of the main features of my RRR technique is versatility.
This case is a perfect example of it. Sometimes the implant placement is not ideal but when DENTOLOGY digital workflow is applied utilizing RRR the result is always good at the end.

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