Guys, I need a lot of help, sep by step.

JKraver

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Definitely one in that lateral area that would bring a good deal of stability.
 
Adi

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Ok, a new case came in , let's see how will it go P_20151208_110109_HDR_1.jpg
 
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Ok, a new case came in , let's see how will it go P_20151208_110338_HDR_1.jpg

Sorry, I'll trim the model later when power is in.
 
Adi

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I chose an angled stock abutment for the blue implant P_20151208_110851_HDR.jpg P_20151208_110914_HDR.jpg
 
JKraver

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Looks pretty strait forward. Show results when done.
 
Adi

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Now this is gonna sound weird or even funny but .. I'll be using the " transfer impression coping " as an abutment
 
JKraver

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I don't know how that will work out... good luck?
 
Adi

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if it were me, I would customize stock abutments...
wax/ acrylic/ and then cast a frame over that with screw access holes in it (cement it all together when finished) but still have it as a screw retained arch.
Andrew, I've been revising what you wrote, thinking: some hexes of the abutments are not parallel , if all of them are attached together, will they be inserted ??
 
JKraver

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You seat abutments in the mouth and they should be parallel, then place bridge over top. You will not be able to do a screw retained bridge like Andrew was saying due to the angle correction abutment. Well you could but it would be very difficult.
 
2thm8kr

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Andrew, I've been revising what you wrote, thinking: some hexes of the abutments are not parallel , if all of them are attached together, will they be inserted ??
Use non engaging stock abutments. Make a seating jig so the doctor can get them oriented right for the POI.
 
zero_zero

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If you can't find non-engaging abutments, you could remove the hex-part or turn it down to a narrow cylinder...
 
Adi

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If you can't find non-engaging abutments, you could remove the hex-part or turn it down to a narrow cylinder...
Say what?!!!! remove the hex ?!!! is that allowable ?
That's a life saver if it is allowable .
 
zero_zero

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For screw retained multi unit restorations you need non-engaging interfaces to take the stress off any particular implant...the screws will act as the weakest link is something has to fail...
 
JMN

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View attachment 20147
I found this on google
from http://www.zimmerdental.com/pdf/lib_guidswpsurgprocd11of11.pdf
no hex , if I really can just remove the hex whenever it comes in the way, then why use angled? just remove the hex and make a bridge like in the picture above
You would have to cut the hex off of the abutment carefully, just enough to let them seat as a group. If you cut any off the flat bottom it could seat onto the implant at a small angle instead of straight down and/or the screws may be too long. Both of which could cause loosening of the screws. You likely knew that, but I'm thinking replacements would be quite difficult for you to get if things go badly. It would work, it's just a higher risk method. And I'm risk shy if there's another way.

Best safe bet if it were me:
Before reducing the abutments, while they are fully screw to the model, lute them together with some acrylic and wrought wire pieces, or even superglue and paperclips, just something to keep them in the same relationship. After acrylic/glue/whatever dries/sets see if you can remove them and put them back onto the model as a set. This will let you see if they are too divergent to make as a single screw retained piece.

If you Can remove them and put them back on as a set: Yippee! modify the abutments as needed and then build a bridge that fits it. You can leave holes on the occlusal surface of the bridge for screw access, cement them to the abutments before delivery to dr or let him cement before seating in pt and let the dr fill the screw access holes with lightcure or whatever after seating.

If they are Not coming off the model and going back on while stuck together:
Modify abutments to parallel, and make a bridge to slide down the abutments just like they are bridge tooth preps. I'd still leave access holes in the occlusal surface for screws and let the dr light cure it closed after seating and cementing. Now, if the bridge ever has to be retrieved, the dr can cut it somewhere interpromial and hard to see, and then lift out the abutments seperately.

This would save the abutments and keep them strong as possible in every situation as they are what is hardest for you to get is what I'm thinking.
Need more explaning of what I typed, please ask, it's 3am my time as I type this and I might have said something stupid again or misunderstood what you are tryimg to do.
Hope that helps some.
 
JKraver

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Say what?!!!! remove the hex ?!!! is that allowable ?
That's a life saver if it is allowable .
Yes, it is allowable if done correctly I wouldn't risk it myself. Try to look for non engaging abutments first. They should offer them.
 
Adi

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Yes, it is allowable if done correctly I wouldn't risk it myself. Try to look for non engaging abutments first. They should offer them.
They never heard of it ,
let me ask you something : isn't a non-engaging abutment simply just an abutment without a hex ?
 
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