Nobel zirconia abutment help

[Affinity]

straw. Works just fine.

I love the american ingenuity, but unfortunately if I took a coffee straw into a swiss lab, im afraid I would be laughed out of the building.. 'Cost effective.. cheaper.. ' these are words they dont know here.. I exaggerate a bit.. ha

 

[Affinity]

I love this technique, I use it all the time with my docs.

So do you make a border or margin where the tissue ends? Or take the composite out further? I guess im a bit confused about how this will translate into the final impression.. like if it will show up in my soft tissue model...

I think my question is, is more composite better? Filling up the socket and then some?

 

[rkm rdt]

Naw I have one propping open my door, I hear that 3shape is giving 7500 for them though for a rebate.

Directly from 3Shape?...I was not offered that here.

 

[actittle]

So do you make a border or margin where the tissue ends? Or take the composite out further? I guess im a bit confused about how this will translate into the final impression.. like if it will show up in my soft tissue model...

I think my question is, is more composite better? Filling up the socket and then some?

Do it just like in the article you posted earlier.

 

[actittle]

Here's a more detailed how-to article.

Custom Impression Coping

 

[rkm rdt]

I think the Dr is going to just use a customized temporary instead of a healing abutment. This will form the emergence profile, and we will use the custom impression coping to make sure it transfers to the PVS.

So your Drs are immediate loading the implant with a temp abutment and crown?

 

[JohnWilson]

Directly from 3Shape?...I was not offered that here.

I believe so, I was talking to mitch from Diadem this last week and he mentioned it. It is for a complete working system, you will get a check from 3shape I believe. Look into it I think you should still be able to pull it off.

 

[rkm rdt]

I believe so, I was talking to mitch from Diadem this last week and he mentioned it. It is for a complete working system, you will get a check from 3shape I believe. Look into it I think you should still be able to pull it off.

I hope so! Thanks for the heads up John,I really appreciate it.

 

[Affinity]

So your Drs are immediate loading the implant with a temp abutment and crown?

Yes, it is a single central, the other option is a healing abutment/flipper right?

Im not sure if it is possible to make an accurate indirect temp without having a working model.. so, I think thats what your question is.. how do you make a temp immediately after the implant is placed..? The pt. has a wire lingual retainer, so the dr might just be planning on a healing abutment with a pre-made temp being bonded to the retainer, until I can make a longer-term temp on a temp abutment.. yet to be determined..

 

[rkm rdt]

I guess my question is; wouldn't you need to make a custom healing abutment first in order to later utilize the custom impression coping?

I thought it was best to "idealize" the tissue at the time of implant placement.In fact I have seen the natural tooth used and modified into a healing cap.

 

[lcmlabforum]

You can make the provisional implant restoration/crown or otherwise from a fixture level
(implant level) impression. or nowadays, the position of the implant platform can be
captured during the surgery with an 'indexing jig' that connects to the adjacent teeth. Then you modify the cast from the prelim impression and wax, convert to a provisional crown. After you refine contours based on how much tissue blanching and 'support' you need, and that could be a few months, then you capture that contour in the custom
impression post. I typically used metal/ti impression posts for that purpose.
Hope that helps.
AC - good to see you on the forum. How's Rick doing?
LCM

 

[Affinity]

You can make the provisional implant restoration/crown or otherwise from a fixture level
(implant level) impression. or nowadays, the position of the implant platform can be
captured during the surgery with an 'indexing jig' that connects to the adjacent teeth. Then you modify the cast from the prelim impression and wax, convert to a provisional crown. After you refine contours based on how much tissue blanching and 'support' you need, and that could be a few months, then you capture that contour in the custom
impression post. I typically used metal/ti impression posts for that purpose.
Hope that helps.
AC - good to see you on the forum. How's Rick doing?
LCM

I like the idea... So what are you using for the indexing jig to record the position of the implant? Do you still need an analog? Do you use a temp abutment? Just wondering how you make an accurate indirect provisional (in this case composite) without going thru the whole process of taking an impression with coping/analog..
Thanks for the info!

 

[Affinity]

I guess my question is; wouldn't you need to make a custom healing abutment first in order to later utilize the custom impression coping?

I thought it was best to "idealize" the tissue at the time of implant placement.In fact I have seen the natural tooth used and modified into a healing cap.

That is what were trying to use the temp for... lizing the tissue at placement.. At least that was what i understood the drs wishes to be...

The problem with the healing cap as i see it, is that you cant really temporize it.. This is ok maybe in the posterior, but not for single central.

I think i mentioned that there is a lingual retention wire that the temp xould possible be bonded to over a healing cap.. But can you make a modified healing cap with composite? Similar i guess to the impression coping.

 

[rkm rdt]

I just don't see the risk/reward of immediate loading.

 

[Affinity]

as a continuation..

I picked up the case today, nobel speedy tri channel implant is placed.. dr used the old temp, (over the healing cap),bonded to the lingual wire, but still wants me to make a custom composite screw retained temp. He sent me an impression coping in a jig, like the aforementioned technique, and I will make the temp on a pre-op model.

Looking thru the catalog, i dont see any angled screw retained temp abutments, just the straight one, and im afraid the screw hole will not be on the lingual.. any suggestions?

 

[actittle]

I have to do screw-retained temps that have the screw access hole going through the incisal quite often. The doc just fills it in with light cured composite after they seat it.

 

[Affinity]

yeah, it just kinda defeats the point of doing an esthetic temp...

zimmer has angled abutments.. but not nobel.. makes no sense...

 

[TheLabGuy]

I just don't see the risk/reward of immediate loading.

In the right cases where there is no chance of any load during osseointegration of that bone I don't see what the hoopla is about not too, sure does help in the natural emergence profile of the gingiva during healing.

 

[actittle]

Plus you can always just make the temp out of occlusion.

 

[rkm rdt]

...and don't eat solids for 6 months.