Graftless solution for multiple unfavorably placed implants using dynamic abutment(®) solutions: A case report with a 3-year follow-up

The employment of implant-supported crowns and bridges has become a well-established and preferred approach in replacing missing teeth. A favorable implant position is mandatory to obtain good esthetic results and ideal emergence of screw access hole. Usually, unfavorably placed implants are the result of insufficient bone volume which leads to implant trajectory in the available bone. Once placed, they are restored giving a cement-retained prosthesis to avoid labial/buccal screw access holes. A graftless solution for this scenario may be using an angulated screw channel technology which corrects the prosthetic screw access hole emergence in an alternative direction which is more esthetic and acceptable. Dynamic Abutment® Solutions system is unique and exclusive and can be used as a true alternative to titanium-angulated abutments or customized Ti abutments designed through computer-aided design and computer-aided manufacturing technologies. The Dynamic Abutment(®) solutions system rectifies angulation issues with millimetric precision up to 30° with full freedom of movement. This case report explains a case where a two-implant supported fixed partial denture was employed in the esthetic zone using Dynamic Abutment(®) Solutions system with angulation rectification by a graftless procedure.