Initial situation
A 48-year-old female patient presented to the IUSD Center for Implant, Esthetic and Innovative Dentistry with an unrestorable maxillary first molar (Fig. 1). The patient had no significant medical history and was not a smoker. Her overall oral health was good, with good oral hygiene. Initial clinical evaluation showed adequate inter-occlusal and medio-distal prosthetic space (Fig. 2). No infection was present, and the soft tissues were of medium thickness, with no recession, and no signs of inflammation. She had a medium smile line and realistic esthetic expectations.
The radiographic assessment showed very divergent roots, no periapical lesions, >4 mm apical to the apexes of the roots, and the presence of a wide inter-septal bone. (Figs. 3,4)
Treatment planning
Intraoral scans of her remaining dentition and virtual occlusal records were taken with an intraoral scanner (Virtuo Vivo™; Institut Straumann AG). Digital Imaging and Communications in Medicine (DICOM) files from CBCT imaging and a Standard Tessellation Language (STL) file from the intraoral scan were imported into an implant planning software program (coDiagnostiX®; Institut Straumann AG). Diagnostic waxing was completed in the same software program (Fig. 5).
