Premilled Vhf approach

In both anterior and posterior scenarios, tissue remodeling is expected, and the need for a second stage to recreate the soft tissue contours would be mandatory after osseointegration. Nonetheless, customized healing abutments can be used in such cases, protecting and containing the bone substitute during healing. Customized healing abutments seem to be an appropriate solution to support and maintain the soft tissue contours after immediate implant placement in both the anterior and posterior regions, simplifying the entire treatment.

Different types of custom abutments are available to date: ceramic, zirconia, or hybrid composite abutments bonded with metal meso structures. A limitation in this type of abutment is the transmucosal height, determined by the availability in the market of bonding links with different heights. The use of pre-milled cylinders offers flexible solutions for both the transmucosal path and the bonding abutment, ensuring an extremely precise machined connection.

In this clinical case, we present an operative protocol carried out completely in-house, thanks to the capabilities of a Vhf R5 milling machine and NT-Trading abutments.