npdynamite
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I believe I know this answer already, and I have seen other threads that touch on it so I think I know what the general opinions about it are, but I wanted to start a thread on this specifically so I can gain an understanding of what is opinion and fact and what is a good idea for ass covering vs. what is legal.
The question is as as the thread says, modifying abutments to make them non engaging. In my years in the lab I have seen this topic come up and based on how the FDA regulates custom abutments it would seem to me that it is not legal to remove the interface from an abutment and make it non-engaging. That said I can see why it might not seem like a big deal when you are working on something like a NobelActive where the conical part of the interface can remain intact and create some sort engagement so that there is more than a screw holding the restoration in place ( have seen a Nobel Trilobe interface removed for this purpose before and that seemed like an a terrible idea, legal or not).
The one situation I see where being able to do this would be a great advantage is when there is a screw retained bridge that you also want angle changing abutments on. Not all companies are making ASC non engaging abutments and some of the companies that are making them are making the interface for the crown so short that the strength of the case would be compromised. In these situations getting an engaging part and removing the engaging aspect could create a better restoration, but it if it puts the lab in legal trouble that doesn't really help. I would like to know how bad of an idea this may be if it were to come up again.
So what do ya'll say? Is this straight up illegal, something to avoid for just in case/CYA reasons, or more of a "if the doctor is aware and ok with it" type of thing?
The question is as as the thread says, modifying abutments to make them non engaging. In my years in the lab I have seen this topic come up and based on how the FDA regulates custom abutments it would seem to me that it is not legal to remove the interface from an abutment and make it non-engaging. That said I can see why it might not seem like a big deal when you are working on something like a NobelActive where the conical part of the interface can remain intact and create some sort engagement so that there is more than a screw holding the restoration in place ( have seen a Nobel Trilobe interface removed for this purpose before and that seemed like an a terrible idea, legal or not).
The one situation I see where being able to do this would be a great advantage is when there is a screw retained bridge that you also want angle changing abutments on. Not all companies are making ASC non engaging abutments and some of the companies that are making them are making the interface for the crown so short that the strength of the case would be compromised. In these situations getting an engaging part and removing the engaging aspect could create a better restoration, but it if it puts the lab in legal trouble that doesn't really help. I would like to know how bad of an idea this may be if it were to come up again.
So what do ya'll say? Is this straight up illegal, something to avoid for just in case/CYA reasons, or more of a "if the doctor is aware and ok with it" type of thing?