N1™ Base
Anterior case
Dr. Francesco Mintrone
Italy
The request of the patient was to replace the fractured tooth and improve her smile, while minimizing the costs. Before starting surgical procedures, we decided to take care of the oral hygiene and periodontal situation. This enabled us to work in a healthy environment at the time of tooth extraction and implant placement. Immediate loading was performed on 21 with a socket shield technique. After the osseointegration of the implant, we decided to proceed with the digital approach to place the final restoration on the implant and a veneer on the other central incisor.
Patient: 51-year-old female, poor oral hygiene, abrasion of the anterior teeth.
Clinical situation: impacted teeth 18, 48, 38. Deep fracture 21.
Surgical solution: extraction and implant placement on 21.
Restorative solution: veneers on 11. Crown on implant on 21.
Surgical treatment: January 18, 2021
Rehabilitation delivery: June 7, 2021
Esthetic analysis
Initial clinical solution
Deep fracture of 21 and severe abrasion of 11.
Initial clinical situation
Tooth residue of 21.
Initial clinical situation
Preoperative orthopantomagram. Incongruous fillings on all four maxillary incisors and impacted teeth 18, 38, and 48. Not visible: periapical lesions at tooth 21.
Treatment planning
Evaluation of the case with DTX Studio™ suite software.
Treatment planning
Evaluation of the case with DTX Studio™ suite software.
Treatment planning
Evaluation of the ideal position of the free gingival margin including crestal bone level assessment.
Treatment planning
Evaluation of the socket shield approach to preserve the buccal bone volume.
Treatment planning
Surgical guide for the 2 mm drill.
Surgical procedure
Provisional prosthesis and soft tissue healing after 90 days (left).
Peri-apical X-ray where the N1 Base and bone stability are visible (right).
Restorative procedure
Mock-up to evaluate the prosthetic profile of the future rehabilitation.
Restorative procedure
Minimally invasive preparation of the veneer on 11, and intraoral scanning.
Restorative procedure
Intraoral scan.
Laboratory procedure
Digital approach.
Laboratory procedure
Digital approach (left).
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP (right).
Laboratory procedure
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP.
Laboratory procedure
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP.
Laboratory procedure
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP.
Laboratory procedure
Insertion tool for IOS implant replica Nobel Biocare N1 NP and RP.
Laboratory procedure
Zirconia stamp to simplify the esthetic result.
Laboratory procedure
Double approach with a zirconia stamp plus veneers cemented on top to simplify the esthetic result.
Outcome
Good soft tissue stability around N1 base before the final delivery (left).
Good esthetic integration of the final rehabilitation (right).
Outcome
Good esthetic integration of the final rehabilitation.
Outcome
Soft tissue stability (left).
Peri-apical X-ray (right).
Outcome
Good esthetic integration of the final rehabilitation.
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