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CLINICAL CASE Step-by-step digitally planned esthetic restoration Igor Ristić and Nikola Vasilić Serbia

Step-by-step digitally planned esthetic restoration

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Page 1: Step-by-step digitally planned esthetic restoration

CLINICAL CASE

Step-by-step digitally planned esthetic restorationIgor Ristić and Nikola VasilićSerbia

Page 2: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 2/37

PatientFemale, 43

Clinical situationloose frontal incisor, bit dislocated over time

Diagnosisvertical root fracture with cast metal post and PFM crown on upper left central incisor

Surgical solutionNobelActive® NP

Restorative solutionTemporary: Temporary Snap Abutment and TempShell Final: NobelProcera® ASC Abutment with e.max Ceram veneering and thin feldspatic veneers on 12,11, 22 FDI

Surgery dateDec 10 / 2016

Final prosthetic delivery Jun 21 / 2017

Total treatment time6 months

Patient with vertically fractured root of an upper central incisor underwent digital planning and immediate narrow platform implant placement in the fresh extraction socket. Bone graft material together with connective tissue graft was used to achieve optimal result.

Igor Ristić and Nikola Vasilic

Page 3: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 3/37

Visible dislocation of upper left central incisor, creating esthetic and functional problems

Initial clinical situation

Treatment planning

Surgical procedure

Restorative procedure

Outcome

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 4: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 4/37

Intraoral pre-treatment situation Intraoral pre-treatment situation - lateral view

Treatment planning

Surgical procedure

Restorative procedure

OutcomeInitial clinical situation

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 5: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 5/37

(CB)CT image of the full arch Bimaxillary intraoral scan with digitally removed upper-left central incisor

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Initial clinical situation

Treatment planning

Surgical procedure

Restorative procedure

Outcome

Page 6: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 6/37

SmartFusion of a (CB)CT scan and intraoral scans in NobelClinician® software

SmartSetup – a digital wax-up proposed by the sofware of upper leftcentral incisor in NobelClinician® software

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Initial clinical situation

Surgical procedure

Restorative procedure

OutcomeTreatment planning

Page 7: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 7/37

Analysis of sagittal aspect of tooth, soft tissues and bone

Initial clinical situation

Surgical procedure

Restorative procedure

OutcomeTreatment planning

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 8: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 8/37

Digital position of implant in planning phase, Temporary Snap Abutment included

Initial clinical situation

Surgical procedure

Restorative procedure

OutcomeTreatment planning

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

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Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 9: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 9/37

Digital design of surgical template in NobelClinician® software Printed NobelGuide® template ready for surgical procedure

Initial clinical situation

Surgical procedure

Restorative procedure

OutcomeTreatment planning

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 10: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 10/37

Digitally designed TempShell in DTX Studio™ design software TempShell milled in local dental laboratory, made from PMMA

Initial clinical situation

Surgical procedure

Restorative procedure

OutcomeTreatment planning

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 11: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 11/37

Intrasulcular incision Forceps adapted to the crown for efficient luxation of the tooth

Initial clinical situation

Surgical procedure

Restorative procedure

OutcomeTreatment planning

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 12: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 12/37

Atraumatic removal of the remaining root structures Cleaning up of the alveolar socket, removing all granulation tissues

Initial clinical situation

Treatment planning

Restorative procedure

OutcomeSurgical procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 13: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 13/37

Try-in of the surgical template intraorally – occlusal view Try-in of the surgical template intraorally – frontal view

Initial clinical situation

Treatment planning

Restorative procedure

OutcomeSurgical procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 14: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 14/37

Guided Twist Drill (10+) 7-13 mm, Ø 2 mm

* As this was a case with immediate implant placement in an extraction site, the Screw Tap was not used, due to the size of the alveolar socket

Initial drilling using Guided Twist Drill*

Initial clinical situation

Treatment planning

Restorative procedure

OutcomeSurgical procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 15: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 15/37

NobelActive® NP 15mm Implant insertion using the NobelGuide® surgical template

Initial clinical situation

Treatment planning

Restorative procedure

OutcomeSurgical procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 16: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 16/37

Final implant positioning Verification of implant position according to the surgical template

Initial clinical situation

Treatment planning

Restorative procedure

OutcomeSurgical procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 17: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 17/37

Harvesting of the connective tissue graft from tuberosity Connective tissue graft

Initial clinical situation

Treatment planning

Restorative procedure

OutcomeSurgical procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 18: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 18/37

creos™ xenogain bovine bone mineral matrix, S (0.2-1.0 mm)

Initial clinical situation

Treatment planning

Restorative procedure

OutcomeSurgical procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 19: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 19/37

creos™ xenogain material is being placed into the gap between the implant and buccal wall of the extraction socket.

Initial clinical situation

Treatment planning

Restorative procedure

OutcomeSurgical procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 20: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 20/37

Try-in of the TempShell – vestibular view Try-in of the TempShell – vestibular view

Initial clinical situation

Treatment planning

Surgical procedure

Restorative procedure

Outcome

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 21: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 21/37

Extraoral picture of the Temporary Snap Abutment

Intraoral pictures after the Temporary Snap Abutment try-in

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 22: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 22/37

Intraoral position of Temporary Snap Abutment is as previously planned Planning position of Temporary Snap Abutment

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 23: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 23/37

Shortening of the Temporary Snap Abutment

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 24: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 24/37

Loading of light cure material for TempShell relining

Positioning of the TempShell Light curing and setting in place of TempShell on the Temporary Snap Abutment

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 25: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 25/37

Temporary Snap Abutment in TempShell after polymerization in right position

Extraoral final contouring of emergence profile on temporary crown

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeInitial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 26: Step-by-step digitally planned esthetic restoration

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Finishing and polishing of emergence profile Removing wings for final placement of TempShell

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

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Finalizing Temporary Snap Abutment for fixation Drilling the screw access hole with Apical Drill

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

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Widening the screw access hole with a diamond burr Placing of temporary crown

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

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Torque value is 15 Ncm for Temporary Snap Abutment Immediate postoperative situation with temporary crown

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

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Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

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Soft tissue final re-shaping prior to impression procedure

Minimal preparation of surrounding teeth Individualized impression coping prior to impression procedure

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

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Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 31: Step-by-step digitally planned esthetic restoration

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NobelProcera® ASC Abutment and veneers on model

Restorations on model, palatal view Individualized NobelProcera® ASC Abutment in zirconia veneered with e.max Ceram

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola VasilicCourtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 32: Step-by-step digitally planned esthetic restoration

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Final torque of Individualized NobelProcera® ASC Abutment is 35 Ncm

Implant restoration immediately after tightening Rest of the restorations bonded on teeth. Screw access hole filled with Teflon™ and light cured composite

Initial clinical situation

Treatment planning

Surgical procedure

OutcomeRestorative procedure

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

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Postoperative intraoral X-ray Superimpositioning of the digital planning as previously done in NobelClinician® software

Initial clinical situation

Treatment planning

Surgical procedure

Restorative procedure

Outcome

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 34: Step-by-step digitally planned esthetic restoration

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Mock-up for finalization of the treatment. Veneers on upper central right and lateral incisors and upper left lateral incisor and canine are planned

Lateral mock-up viewIntraoral view of the mock-up

Initial clinical situation

Treatment planning

Surgical procedure

Restorative procedure

Outcome

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 35: Step-by-step digitally planned esthetic restoration

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Intraoral view of finished NobelProcera® ASC Abutment Perfect blend of restorative materials with natural tissues, immediate postoperative photo

Initial clinical situation

Treatment planning

Surgical procedure

Restorative procedure

Outcome

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 36: Step-by-step digitally planned esthetic restoration

Case courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic 36/37

X-ray with implant and restoration after final prosthetic delivery

Final smile of the satisfied patient

Initial clinical situation

Treatment planning

Surgical procedure

Restorative procedure

Outcome

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Courtesy of Dr. Igor Ristić and Dr. Nikola Vasilic

Page 37: Step-by-step digitally planned esthetic restoration

Case courtesy of Igor Ristić and Nikola Vasilic

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