Techniques for implant pick up

[Slipstream]

I don't see them comming in cheaper than a custom cad/cam zirconia abutment really. Its just a different technique to achieve the same result, without using cad/cam.

We are starting to produce the Ankylos custom abutments in full Zr and Ti which may make life easier if you get anymore tricky ones like this, available in C X and Xive.

Not particularly cheap, but for the cases that need them, they are handy to have, and not clones so no warranty issues.

Colin

 

[paulg100]

Thanks for the info Colin, thats handy to know, might come in useful.

However using the technique with emax, i retain full control and get to keep all my profit in house so obviously preferable

Also not interested in using 1 piece ZR abutments. Apart from the breakage reports, the bedding in issue means its just a lot of hassle to have to get the patient back in, remove the bridge/crowns and re-torque after a few weeks.

The hybrid zr/emax abutments with metal insert and there for titanium against titanium fixture interface is preferable for me.

 

[Alistar]

Paul, you ever try Strauman? I'm not sure of the exact numbers, but I know we have over 500 custom abutments out there and well over half are zir. No failures or re-torques yet.

I know you're at the mercy of the surgeon and gp, but it never hurts to jog their brain.

Tough case! End result looks excellent Paul. I think I'll pick up that Quitessence with that E.max technique

 

[paulg100]

Alistar:

"Paul, you ever try Strauman?"
Yep im a straumann platinum tech.

When i brought the issue of the cad/cam 1 peice zirconia abutments up at the last straumann platinum meeting,they confirmed them selves that there had been some failures. It may have been poor design or case selection i dont know, but i think Mark Jackson also confirmed on here that he had higher than normal failure when doing these (not sure what system).

Also when you say no re-torque issues, This is not something you wait to present itself when a problem arises. Its something that should be a matter of protocol as stanbdard, at least with Ankylos, and i imagine the same applies to all 1 peice systems.

Zirconia is harder than titanium. The micro irregularities in the interface of the zirconia mean that it takes some time to wear in to the titanium interface. Once this has happened, it causes the torque to loosen. The worse the milling the bigger the problem. Ive seen studies presented for Ankylos, maybe you should ask straumann for their data. Besides your Dr's placing these should be aware of this issue, wether they decide to do this or turn a blind eye......

This is one big advantage of the hybrid zirconia abutments or pressed emax abutments, with a titanium insert/interface.

 

[Slipstream]

The surgeons seen to have their differing ideas - we dont manufacture any full Zr restorations, as one of our Directors has no time for them. Yet I come across labs who insist that is what their clients want and dont trust hybrid inplants with a titanium interface

I was speaking to one of the large dental hospitals who confirm they are seeing more and more failed solid Zirconia implants, mainly the narrow size, but not exclusively.

Looks like we will stick with the Ti base and solid metal manufacturing inhouse, the Ankylos custom abutments in Zr are available for those who deem them suitable for their case.

 

[lcmlabforum]

You mean the solid zirconia implants like White Sky/z-lock's type, or solid zirconia abutments? If it is solid zirconia, I assume you are not referring the the hybrid Roxolids.
LCM

 

[harry1]

The surgeons seen to have their differing ideas - we dont manufacture any full Zr restorations, as one of our Directors has no time for them. Yet I come across labs who insist that is what their clients want and dont trust hybrid inplants with a titanium interface

I was speaking to one of the large dental hospitals who confirm they are seeing more and more failed solid Zirconia implants, mainly the narrow size, but not exclusively.

Looks like we will stick with the Ti base and solid metal manufacturing inhouse, the Ankylos custom abutments in Zr are available for those who deem them suitable for their case.


With little implant experience, apologies in advance for what may seem a silly question, I see aesthetic and biocompatability benefits in replacing metal with Zirconia for crowns & bridges and the odd aesthetic benefit in replacing metal abutments with zirconia, but what are the greater benefits for using zirconia customised abutments?
Concerns me that much time, cost and resources are applied in the making of large span implant bridges, etc (simlar to Ali's excellent efforts recently shown) over zirconia customised abutments, which may be seen as a weak link in this treatment.
Again apologies if I've missed something, welcome some feedback.

 

[paulg100]

i see the main benefit as aesthetics, especially for anterior work.

But you can achieve the same with a hybrid abutment in this respect.

The down side to these hybrids is that you introduce another potential failure point into the equation. Guess we wont know how big an issue this is until some study data is released for them, haven't seen any yet myself.

As long as this is small then i think the aesthetic positives far out weigh the negatives.

These hybrids have CE and FDA approval so they at least meet their requirements.

 

[Slipstream]

Hybrid


Where the screw is torq'd onto a titanium "adaptor" transfering any flex stresses to the zirconia "collar" across a much larger area than if the screw was set directly through the zirconia and tightened onto zirconia.

Solid Zirconia



I guess the arguement has to be does the ti/zr interface offer a more likely failure point than a narrow Zr neck with a screw under tension?

Cosmetically they both offer very similar properties over 1 piece metal abutments

 

[harry1]

Thank you gents for your reply's, appreciated.