Digital Workflow for Designing CAD-CAM Custom Abutments of Immediate Implants Based on the Natural Emergence Profile of the Tooth to be Extracted

The aim of this report is to present a digital workflow technique to design a customized abutment for provisionalization of an implant immediately placed based on the natural emergence profile of the tooth to be extracted. The workflow involves the combination of intraoral and cone beam computerized tomography scans, from which 3-dimensional reconstructions of soft tissue and alveolar bone, as well as reconstructions of the tooth to be extracted, are obtained and exported as standard tessellation language files. The files are imported to a computer-aided design software, in which a virtual wax-up and custom abutment design are performed considering the natural emergence profile of the patient's tooth prior to extraction. Since the customized abutment is digitally designed, it can also be used as a scan body, to be directly scanned intraorally after soft tissue healing around an interim implant restoration. The custom abutment digitally designed then can be produced by milling zirconia with an optimally chosen color, in accordance with the esthetic needs of the patient.