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12 CASE STUDY pro le is designed extraorally with compos- ite (Figs. 8 to 12) . To facilitate removing and inserting the temporary restoration, trepanation can be provided occlusally through the temporary shell restoration to the opening in the multifunctional cap. The intended instrument can now be screwed into this opening and allows insertion and removal of the temporary restoration (see Figs. 14 and 15) . Third option for fabricating a temporary restoration The third variant for temporary restorations combines the use of a simple orientation template with the preparation of an imme- diate temporary restoration. In this case a deep-drawn splint is fabricated on a model for the template. Prior to deep-drawing the foil, a plastic tooth is placed in the position of the missing and to be implanted tooth (Fig. 13) . Initially this tooth simulates the later prosthetic restoration. Based on this set-up, the implant position is planned (backward planning) and marked on the model. After deep-drawing of the foil, the tooth is held by the deep-drawn splint. This is followed by drilling through the splint and the set up plastic tooth (Fig. 14) . Then the splint with the tooth is removed from the model and tooth and splint are separat- ed. The plastic tooth is ground basally and the shell is then replaced in the splint. The orientation template is inserted intra-oper- atively and pilot drilling with a diameter of 2.8 mm is performed through the opening in the template. The splint is removed for form drilling and the implant is then in- serted. The further procedure corresponds to the above mentioned procedure for con- necting a temporary shell restoration to the multifunctional cap. The difference being that the plastic tooth is inserted with the splint and thus brought precisely to the position previously planned on the model (Fig. 15) . After curing the rst portion of ow composite, the splint is removed from the mouth and then the multifunctional cap with the attached plastic tooth. After shaping the desired emergence pro le with composite, the temporary restoration is mounted on the implant base (Figs. 16 to 18) . An occlusal check is to be observed in gen- eral for all temporary restorations. Here, all occlusal and articulation contacts which could lead to loading must be removed (Fig. 19) . The patients are given dietary recommendations and strict instructions not to load the temporary restored implant during the rst 6 weeks. Conclusion Transgingival healing with a temporary im- mediate restoration offers enormous ad- vantages in certain indications, as a num- ber of studies have meanwhile con rmed. The pre-mounted iSy Implant base remains on the implant after insertion and acts as support framework for the gingiva former and the temporary restoration. The idea behind the iSy concept not only shortens the clinician’s “chairside” time, but also reduces surgical effort and thus the costs for the restoration with implant-supported tooth replacement. Many patients with a limited budget can therefore gain simple and cost-reduced access to implant-sup- ported prosthetics. Fig. 9: To fabricate a chairside temporary restoration, the same multifunctional cap is trimmed so that it ts underneath the temporary shell restoration. Fig. 10: A stable soft tissue collar surrounds the iSy Implant and the pre-mounted implant base. Fig. 8: Multifunctional cap mounted on the implant base. Fig. 16: The temporary shell restoration is connected to the multifunctional cap in the mouth using composite. Fig. 15: Deep-drawn splint inserted in the mouth with basally ground plastic tooth. Fig. 14: Both the splint and the plastic tooth were trepanned to prepare the orientation template for insertion.