Department of Prosthodontics and Biomaterials, Centre for Implantology, University Hospital Aachen, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
Int J Implant Dent. 2022 Sep 6;8(1):35. doi: 10.1186/s40729-022-00434-2.
The patient-centered SafetyCrown-workflow enables the immediate restoration of posterior missing teeth and short free-end situations following one-abutment/one-time within three visits and only one surgical approach. This prosthodontic rehabilitation aims to combine the advantages of cemented and screw-retained restorations.
The concept has been performed with 4 restorations in 3 patients and followed up for up to 1 year (mean: 11.2 months) without technical and/or biological complication. Visit 1: Intraoral optical impression, CBCT, and tooth shade selection. Virtual implant planning is performed, and a surgical guide is printed. After exporting the planned implant position, a tooth-colored abutment is fabricated from zirconia with a 1-mm supragingival cementation line, adhesively bonded to a titanium base. Visit 2: Fully navigated implant placement with insertion of the definitive abutment. Subsequently, optical impressions are prepared for A: immediate restoration using a PMMA crown without functional contacts; B: definitive crown fabricated from monolithic zirconia and individualized. The localization of the screw channel is marked using stain thus permitting precise screw channel access, if necessary. Visit 3: After osseointegration of the implant, the definitive crown is adhesively cemented supragingival. In a retrospective analysis of PROMs ('How stressful was the treatment process […]?' (0 = not stressful at all, 100 = very stressful), mean VAS score for SafetyCrown of 14 (SD 11.7) and 29.8 (SD 23.1) for standard procedure were present.
The SafetyCrown offers a shortened, patient-oriented concept for implant-supported single-tooth reconstructions omitting second-stage surgery. Clinical performance and hypothesized prosthodontic benefits require confirmation via an RCT.
以患者为中心的 SafetyCrown 工作流程可在三个就诊日内，通过一次手术入路和一个基台，即刻修复后牙单个缺失牙和短游离端情况。这种修复体旨在结合粘结固位和螺丝固位修复体的优势。
该理念已在 3 名患者的 4 个修复体中实施，并进行了长达 1 年（平均：11.2 个月）的随访，未出现技术和/或生物学并发症。就诊 1：口内光学印模、CBCT 和牙齿比色选择。虚拟种植体规划，并打印手术导板。在导出计划的种植体位置后，从氧化锆制造出带有 1 毫米龈上粘结线的牙色基台，并用粘合剂粘接到钛基底上。就诊 2：使用全导航植入物放置，并插入最终基台。随后，准备光学印模，A：使用无功能接触的 PMMA 冠即刻修复；B：由整体氧化锆和个体化制造的最终冠。使用染色标记螺丝通道的位置，从而在必要时可以精确进入螺丝通道。就诊 3：种植体骨整合后，将最终冠用粘合剂粘接到龈上。在 PROM 的回顾性分析中（“治疗过程有压力吗？[...]”（0=一点也不有压力，100=非常有压力），SafetyCrown 的平均 VAS 评分为 14（SD 11.7），标准程序为 29.8（SD 23.1）。
SafetyCrown 为单颗种植体修复提供了一种缩短的、以患者为中心的概念，无需二期手术。临床性能和假设的修复体优势需要通过 RCT 来证实。
