Brett Hansen CDT
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So I have this doctor in a city about 40 miles from my lab. I called her after an implant case she sent me had margins that were 4+ mm below the gingival crest. She told me that her periodontist/oral surgeon sends her the patients with the abutments already placed. On this case I was able to explain to her why she should have that abutment removed and let me do a custom abutment. She and the patient were very happy with the results on that case.
After that case, the doctor told her oral surgeon not to place the abutments anymore and that she would take an implant level impression and then send it to me to choose the best abutment options for the restoration. This obviously made me very happy because i hate working on cases that are compromised by a poor abutment choice and we make more money on the case.
The next case comes up and she faxes me the implant description. We were restoring a RN and a WN snyocta implants on a bi and a molar. I ordered open tray imp copings for her. The impression comes in and there is impression material overlapping the WN imp coping on the distal side...she obviously didn't get the imp coping seated. I called her and let her know what I saw and told her that she could take a X-ray to be sure that she got those imp copings seated before the impression was taken. The new impression comes in...WN looks great...RN is dislodged. I pushed the RN coping into the impression and it seemed to snap into place, but there was a gap between the impression and the imp coping. This told me that someone tried to remove the impression from the patient's mouth before the screw on the RN imp coping was completely unscrewed. I thought that the impression was still ok and I really didn't want to call the doctor and tell her she needed a third impression.
To finish this up...the bi was way off...we ended up remaking the crown.
I told the doctor everything that I saw from my end and I apologized for not doing my job to make this process easy on her. I also told her that I will get her the closed tray imp copings from now on.
I assumed that using an open tray technique was common and second nature to dentists...it obviously isn't and I should have made sure of that before I chose the type of imp copings for her. She is still happy with me and knows that we are doing things the right way, so this lesson wasn't a painful one for me to learn.
After that case, the doctor told her oral surgeon not to place the abutments anymore and that she would take an implant level impression and then send it to me to choose the best abutment options for the restoration. This obviously made me very happy because i hate working on cases that are compromised by a poor abutment choice and we make more money on the case.
The next case comes up and she faxes me the implant description. We were restoring a RN and a WN snyocta implants on a bi and a molar. I ordered open tray imp copings for her. The impression comes in and there is impression material overlapping the WN imp coping on the distal side...she obviously didn't get the imp coping seated. I called her and let her know what I saw and told her that she could take a X-ray to be sure that she got those imp copings seated before the impression was taken. The new impression comes in...WN looks great...RN is dislodged. I pushed the RN coping into the impression and it seemed to snap into place, but there was a gap between the impression and the imp coping. This told me that someone tried to remove the impression from the patient's mouth before the screw on the RN imp coping was completely unscrewed. I thought that the impression was still ok and I really didn't want to call the doctor and tell her she needed a third impression.
To finish this up...the bi was way off...we ended up remaking the crown.
I told the doctor everything that I saw from my end and I apologized for not doing my job to make this process easy on her. I also told her that I will get her the closed tray imp copings from now on.
I assumed that using an open tray technique was common and second nature to dentists...it obviously isn't and I should have made sure of that before I chose the type of imp copings for her. She is still happy with me and knows that we are doing things the right way, so this lesson wasn't a painful one for me to learn.
