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logo 39 • the CAMLOG Partner Magazine • November 2016 16 CASE STUDY Abb. 27: The raw-fired crowns on the master model prior to try-in in the mouth. Fig. 33: The emergence profile of the implant restoration needs to be adapted to the cervical profile of partial crown 21. Fig. 32: Function and esthetics were checked during the raw-fired try-in of the crowns in the mouth. Fig. 31: Increased pressure of the hybrid abutment on the peri-implant tissue is clearly visible. In a subsequent session, the other teeth of the corresponding quadrants were ground (Figs. 25 and 26) . This way, the supporting regions were never completely disbanded [4]. Centric bite compound registers were lined step-by- step and served to correctly transfer the adjusted bite position. Impression taking of the maxilla and mandible was performed only after healing of the marginal gingiva. The shaped emergence profile of implant 11 was copied onto the impression post with autopolymerizing material. For checking the precision of the fit and occlusion, the posterior crowns (IPS e.Max Press; Ivoclar Vivadent, Schaan/ Liechtenstein) and the anterior partial crowns (Creation CP, Creation Willi Geller, Meinigen/Austria) were checked on the patient prior to glass firing (Figs. 27 to 33) . The emergence profile of implant crown 11 was still to be widened somewhat by the laboratory and adapted to the gingiva pattern of the adjacent tooth 21 (Abutment: DEDICAM, CAMLOG; crown: Creation CP, Creation Willi Geller, Meinigen/Austria). Variolink II (Ivoclar Vivadent, Schaan/ Liechtenstein) was used for final cementing, anterior teeth in the mandible were then built up with composite (Tetric EvoCeram, Ivoclar Vivadent, Schaan/ Liechtenstein) (Figs. 34 to 38) . To protect the new restoration the patient was given a splint for the night. Follow-up Follow-ups were performed at short intervals initially. The patient soon grew accustomed to the new restoration. As the patient continues to smoke, he attends our practice three times per year for prophylaxis. As a result of the good doctor-patient relationship, close cooperation with the dental laboratory and a reliable treatment strategy, a perfect result was achieved. In particular, the modified lip appearance with extension of the anterior teeth and the desired closure of the diastema were met with positive approval in the patient's social environment. Figures 39 to 42 show the final images of the definitive work after more than 2 years in situ. Discussion The case study focuses on the essentials and gives an idea of the complexity and effort for a complete restoration on natural teeth and an anterior tooth implant. Despite the difficult initial situation with a missing buccal lamella, it was possible to realize adequate implant restoration with a harmonious gingiva pattern. Autologous bone remains the gold standard among augmentation materials and allows reliable reconstruction of buccal defects. Shaping of the soft tissue with a long-term temporary restoration and the application of composite according to standard principles resulted in reliable harmonization and formation of the papillae [5]. The peri-implant hard and soft tissue in particular, are the decisive parameters for a stable long-term outcome. It remains to be seen whether this also applies to smokers in the sense of a biological "protective barrier" [6]. The implant has now been in- situ for four years. Fig. 25: Impression taking in the maxilla of the implant and the prepared teeth. Fig. 26: The posterior teeth in the mandible were to be restored first. The anterior teeth were to be built up later.