Ankylos Implant System

rkm rdt

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Has anyone worked with Ankylos implants?
 
TheLabGuy

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Yes I have, and I bitch about it every time I have to deal with them. You can't cad/cam them, you can't order a cast-to UCLA, only stock abutments at this time. Then to add to the frustration, the stock abutments only come at a couple tissue heights, nothing like doing an implant that the stock abutment sits 2mm off the tissue and their isn't anything you can do about it because the stock abutment is so tapered below the margin. Then if you haven't totally gone off the deep end by now, they are not indexed either, so you have to make an abutment seating jig. I've heard they have come out with implant screws that are now indexed and they are still a few months away from being able to cad/cam them as well, but they are a pain in the keester currently. Welcome to limited implant dentistry.
 
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doug

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Rob, How do they index the screw? BTW, I'm not familiar with the Anklyos system
 
TheLabGuy

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An indexed screw has some type of notched implant platform or head to it (almost all implant systems do these days). Ankylos don't, they spin around like the room does after a night of too much drinking!!!!!! Hence why a jig has to be fabricated, which isn't a problem, I usually always fabricate one anyways but it's the fact that the Dentist 'must' use it or they'll never know where to seat the abutment correctly.
 
TheLabGuy

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Oh Doug, after reading what I just wrote, I'm sorry to confuse you, I don't mean the abutment screw.....that's not indexed, I'm talking about what the Dentist or Surgeon screws into the patients bone, the actual implant or as I called it, the implant screw.
 
dmonwaxa

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Ankylos can be dicey to work with I agree, but in fairness thats any system you're unfamilair with. We have been conditioned to see some sort of antirotational element whether it's a hex, octagon or micky mouse ears. I've had issues with them all. The weakness as Rob mentoioned is the lack of a cast to UCLA abutment and thats archane,; however thats soon to change with CAD/ CAM. I work on a daily basis with Ankylos and it can prove to be very flexible. Some see the lack of an antirotational element in the conventional sense as a weakness but when using stock abutments especially angled it offers great flexibility in obtaining the ideal angle and path of insertion. I've used indexed stock abutments from other systems in the past and found this to be an issue also; move it one click over and its too much or too little. The cold weld that occurs in the morse taper can be difficult to disengage, its that tight so there is little or no possibility of it moving if properly torqued.
 
dmonwaxa

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An indexed screw has some type of notched implant platform or head to it (almost all implant systems do these days). Ankylos don't, they spin around like the room does after a night of too much drinking!!!!!! Hence why a jig has to be fabricated, which isn't a problem, I usually always fabricate one anyways but it's the fact that the Dentist 'must' use it or they'll never know where to seat the abutment correctly.

There are benefits to using a seating with any system; even if they're indexed. I've seen dentists also struggle when placing abutments of indexed systems. A jig is a great time saver.
 
doug

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All of our bone level implants go out with a seating jig. I can't imagine trying to get past the tissue to engage an implant that's that deep.
 
dmonwaxa

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All of our bone level implants go out with a seating jig. I can't imagine trying to get past the tissue to engage an implant that's that deep.

Great point Doug. Some folks seem to think that Ankylos is the only system that require a seating jig; thats a big big misconception.
 
rkm rdt

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One technique is for the Dr to place the stock abutment intraorally.He then fabricates the seating jig with light cure.

The jig can now be sent to the lab with the abutment however there is no need to take a final impression.

The lab connects the analog to the abutment.Then the study model is modfied to receive the jig with the abutment/analog assembly.

By grinding a socket into model with a carbide, the analog is positioned with the jig and luted into place with resin or light cure composite.

You now have a working model.
 
dmonwaxa

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One technique is for the Dr to place the stock abutment intraorally.He then fabricates the seating jig with light cure.

The jig can now be sent to the lab with the abutment however there is no need to take a final impression.

The lab connects the analog to the abutment.Then the study model is modfied to receive the jig with the abutment/analog assembly.

By grinding a socket into model with a carbide, the analog is positioned with the jig and luted into place with resin or light cure composite.

You now have a working model.

Yes and no, yes its possible but here is a few points to consider.

1. Likliehood of the doc actually taking the time to make the jig; a wasted appt maybe and not good use of his or her time.

2. Also it depends on the type of abutment, standard or balanced. Standard has an integrated center screw thats not independent of the abutment, whereas the balanced screw rotates independently of the abutment.

3. The expansion of the stone used for preliminary models; more critical for multi units.
 
JohnWilson

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One technique is for the Dr to place the stock abutment intraorally.He then fabricates the seating jig with light cure.

The jig can now be sent to the lab with the abutment however there is no need to take a final impression.

The lab connects the analog to the abutment.Then the study model is modfied to receive the jig with the abutment/analog assembly.

By grinding a socket into model with a carbide, the analog is positioned with the jig and luted into place with resin or light cure composite.

You now have a working model.


I have a client that does this with every fixture not just ankylos, they make a jig at the time of surgery with a standard transfer assembly. We modify the preop model as described and fab a custom abutment/temp crown to train the soft tissue. We fabricate a duplicate die of the custom abutment that the OS sends to the restoring doctor so they can take a standard Crown and bridge impression for fabrication of the definitive crown. This allows the soft tissue to be maintained and not disturbed trying to retract it to capture margins.
 
dmonwaxa

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I have a client that does this with every fixture not just ankylos, they make a jig at the time of surgery with a standard transfer assembly. We modify the preop model as described and fab a custom abutment/temp crown to train the soft tissue. We fabricate a duplicate die of the custom abutment that the OS sends to the restoring doctor so they can take a standard Crown and bridge impression for fabrication of the definitive crown. This allows the soft tissue to be maintained and not disturbed trying to retract it to capture margins.

John are you fabricating custom abuts for Ankylos?

When a transfer jig as described above is used to create the model for Ankylos implant is it the standard abutment or C- balanced abutment?

Also I see the technique you use still rely on a final impression being taken; from what rkm stated it was my understanding it would negate taking a final impression.
 
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rkm rdt

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I have not tried this proceedure yet. I learned about it on Friday during the Ankylos course I was on.

The idea was to disregard the soft tissue. Design the emergence profile as if it were the natural tooth.Therefore deep margins were preferred ( 3-4 mm if possible).

Use a water soluable cement not resin based.

He showed evidence that the soft tissue would connect to the restoration in time therefore the gingia would recontour around the crown on it's own.
The same approach with bridge pontics , deep conical shape as a natural tooth.

I question the accuracy of using a study model also. I have seen some very poor samples in my days.

The other point about the course was to reduce the need of a custom abutment.This was of course from a dentist's point of view.
 
CRWNMKR

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If the ankylos implant is placed shallow , you are screwed , one of the worst restorative options out there.
 
rkm rdt

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Worse than encode?
 
doug

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Encode is a lot better these days. You can only do what you're able to if the implant isn't deep enough, that holds for every system.
 
JohnWilson

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John are you fabricating custom abuts for Ankylos?

NO,

Luckily for me Ankylos is not very popular out in my neck of the woods. Its my understanding that there isn't a cad/cam system doing these yet ???

My post was just adding to the statement of how to utilize a jig from a one stage surgery for a predictable outcome.

Sorry if I hijacked the thread, I was just trying to add info.
 
dmonwaxa

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NO,

Luckily for me Ankylos is not very popular out in my neck of the woods. Its my understanding that there isn't a cad/cam system doing these yet ???

My post was just adding to the statement of how to utilize a jig from a one stage surgery for a predictable outcome.

Sorry if I hijacked the thread, I was just trying to add info.

John, no you didn't hijack the thread. I just wanted to be certain. I know Ankylos CAD custom abuments is around the corner or so I've heard. Regarding Ankylos, I was also questioning whether the stock abutments were being torqued, indexed with transfer jig sent to the lab with a new abutment for crown fab, That would be an additional cost of an abutment
 

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