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20 Fig. 34: Second case study: Insertion of two iSy implants with diameter of 4.4 mm, length 11 mm. Fig. 35: Situation after two months’ transgingival healing. Fig. 36: Occlusal view of the implant bases. Preparation of tooth 35 for a full ceramic crown. Fig. 41 and 42: The hybrid abutment crowns were screwed in from the occlusal approach. The screw channel was sealed with a filling composite. Fig. 40: Two weeks after the impression taking and the bite registration the implant bases were removed. Second case study: Functional restoration in the lateral area For the second case study, two iSy implants were used in the lateral area regio 36 and 37. The implant placement was carried out in August 2013. The surgical and prosthetic protocol could be reduced to a minimum in accordance with the underly- ing concept of the iSy Implant System. No additional augmentation measures were carried out apart from buccal insertion of bone chips harvested during the prepara- tion of the implant bed. The clinical pro- tocol adhered to the familiar iSy concept with transgingival healing. We achieved the final restoration very quickly from im- plant placement, osseointegration, and soft tissue healing as well as impression taking and bite registration. The final full ceramic restorations (IPS e.max ® Press, Ivoclar Vivadent) were screw-retained occlusally. The ceramic crowns were fabricated in the laboratory as a single unit, stained and glazed, and bonded to the iSy titanium bases with Multilink ® implant using CAD/CAM. The ceramic surface in the screw channel was etched extraorally with 5% hydrofluo- ric acid and silanized (Monobond Plus, Ivoclar Vivadent). After insertion of the hybrid abutment crowns, these were tight- ened with 20 Ncm. The screw channel was then sealed up completely and esthetically with filling composite (Fig. 34 to 44) . The clinical and radiographic situation 25 months after implant placement can be seen in Figures 45 and 46 . The treatment outcome is functionally and esthetically stable. The highly efficient and safe use of the iSy Implant System was able to maxi- mize the cost/benefit ratio for the patient. I would like to thank MDT Herbert Hasler, Murnau, for his assistance with the dental technician aspects of this case. Conclusion The iSy Implant System is an absolute plus for our implant dentistry treatment spec- trum. The motivation for us to use iSy lies in the well thought-out and patient- appropriate product concept. The obvious transgingival approach resulting from the premounted implant base offers a number of advantages. The final restoration can be carried out with this two-part implant sys- tem with only a single abutment change, with corresponding positive outcomes for the biology of the hard and soft tissue [2]. Platform switching will soon be incorporat- ed into the system with a conical implant- abutment connection and also offers a number of advantages [3, 4]. A slightly subcrestal positioning of the iSy implant encourages adequate gingival thickness when combined with platform switching – and soft tissue augmentation where necessary – which has positive outcomes for preserving the crestal bone level [5]. That iSy is also economically very attrac- tive for all those concerned may encour- age opting for an implant therapy concept and satisfies patient requests for prosthet- ic restorations that combine esthetics, function, and long-term stability. Fig. 43: The clinical result immediately after the placement. CASE STUDY