Editorial Type:
Article Category: Case Report
 | 
Online Publication Date: 16 Feb 2023

The Use of a Coded Healing Abutment in the Restoration of a Single, Immediately Placed Implant in the Esthetic Zone: A Clinical Case Report

BDS, MS, MPH, FRCD(C)
Page Range: 279 – 285
DOI: 10.1563/aaid-joi-D-22-00187
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For several years, the implant-level impression procedure started by removal of the healing abutment, followed by connection of the impression coping to the implant. Encode Complete (Encode, Biomet 3i, Biomet 3i, Palm Beach Gardens, FL) was introduced to eliminate implant-level impressions by offering a healing abutment-level impression protocol. This report illustrated the treatment of a single tooth in the anterior esthetic zone using Encode Complete. A 23-year-old female patient reported to the prosthodontics clinic complaining of a fractured maxillary anterior tooth that was deemed nonrestorable. After immediate implant placement, soft tissue preservation and temporization of the implant, healing abutment level impression was made. The codes embedded on the occlusal surface communicated the implant depth, hex-orientation, platform diameter, and interface. The definitive Encode gold-plated titanium abutment was anatomically designed virtually with customized margin, contour, taper, and emergence profile. The milling process was initiated, and the virtual design data were sent to the Robocast Center for analog placement in the original Encode master cast. The definitive abutment was placed on the master cast using Robocast technology, followed by the fabrication of the final porcelain fused to zirconia cement-retained all ceramic crown. The abutment was secured to the implant with a Gold-Tite abutment screw, followed by the final cement-retained implant crown placement. Recall visits were obtained at 1 week, 1 month, 3 months, and 1 year after final prosthesis insertion.

Figure 1.
Figure 1.

Fractured tooth #7.


Figure 2.
Figure 2.

Transfer JIG to index the implant position in relation to the adjacent hard tissue.


Figure 3.
Figure 3.

Transfer JIG impression coping analog assembly on the master cast.


Figure 4.
Figure 4.

(a) Emergence profile transfer to the master cast using the coronal third of the root. (b) The gingival replication material injected in the template around the coronal third of the root. (c) Screw retained temporary crown fabrication. (d) Finished and polished provisional crown.


Figure 5.
Figure 5.

(a) Soft tissue maturation after removal of the provisional crown. (b) Encode healing abutment. (c) Encode healing abutment in place ready for final impression making. (d) Master cast after retrieval from the final impression.


Figure 6.
Figure 6.

(a) Adesso split mounting plates. (b) Mounted casts on Stratos articulator.


Figure 7.
Figure 7.

2D image of the custom abutment design.


Figure 8.
Figure 8.

Encode robotic analog placement.


Figure 9.
Figure 9.

(a) Customized gold-plated titanium abutment. (b) Final crown.


Contributor Notes

Corresponding author, e-mail: eaattar@kau.edu.sa or esrattar@gmail.com
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