3i Certain Zirconia custom abutment

[JohnWilson]

Don't you hate it when someone make remarks like this to blame someone without checking first?
Negativity begets more negativity. Feel so sorry for you, John, that the Dr would even assumed
the rep was right and you were wrong.

Yeah it was a shock, because I had a limited amount of BellaTech milled abutments they ASSUMED I was a newbie.

Its amazing what a suit can do to influence you.

BTW This is how I handled the situation with the client,

Dr X

So sorry to hear you had issues with this case, I understand the rep stated it was a lab screw but I can assure you that its the final screw that was sent with the case. Oh yes Dr I understand the REP states it should be a gold screw but this is the proper screw. Yes yes I am sure Dr, lets go over your delivery protocol. Did you use a torque wrench?, oh you didn't have one? Oh you just used the hand driver? I see, well I think we found your problem. Yes Dr X a torque wrench is mandatory, did the rep not offer to loan you one when he suggested you do this case as an encode? Oh he ASSUMED again that you had one? I understand well lets get one to you, I can loan you one or you can contact your rep. Oh BTW just to be on the safe side I will send you a new screw at my expense so we can be certain that we have our bases covered. Oh the rep already ordered you a gold one? Why don't you just cancel that and when my screw and torque wrench arrive please call me so we may go over the protocol to deliver this unit appropriately. Oh your welcome Dr things happen but understand we are here to make sure you have successful cases and happy patients. Have a great day.

When I hung that phone up I was gritting my teeth so bad that I couldn't call corporate fast enough.

OH well sometimes business is just a pain in the ass but I think I handled it pretty good.

 

[lcmlabforum]

So sorry to hear that. I just had dinner with 4 other DDS and they were just talking
about unreasonable expectations. One of them will do anything to make them feel better
but I am more rigid. All it matters at the end of the day so that we don't burn out
our stomach lining or go home angry and give our little ones less than a happy hug.
Don't forget to consider latest research on how inaccurate Encode system is.
J Prosthet Dent. 2013 Aug;110(2):90-100. doi: 10.1016/S0022-3913(13)60346-7.
An in vitro comparison of the accuracy of implant impressions with coded healing abutments and different implant angulations.
Al-Abdullah K, Zandparsa R, Finkelman M, Hirayama H.
Source
Adjunct instructor, Postgraduate Prosthodontic Division, Tufts University School of Dental Medicine, Boston, Mass. Electronic address: [email protected].
Abstract
STATEMENT OF PROBLEM:
Fabricating implant definitive casts with CAD/CAM technology (Robocasts) from coded healing abutment impressions represents a simpler and innovative alternative to conventional implant impression techniques. However, information about the accuracy of the impressions and the resultant definitive casts is limited.
PURPOSE:
The purpose of the study was to evaluate the accuracy of the Robocasts and compare them to those definitive casts fabricated with conventional implant impression techniques (open tray with splinted impression copings technique).
MATERIAL AND METHODS:
A reference epoxy resin cast was fabricated and shaped to simulate a dental arch. Two regular platform implant replicas (Biomet 3i Certain, 4.1 mm diameter and 15 mm length) with internal connections were placed 10 mm apart with a 10-degree convergence for one side of the reference resin cast and a 30-degree convergence for the other. Coded healing abutments (Encode) were placed at 3 different heights above the level of the soft tissue replication material (approximately 1, 2, and 4 mm) and served as test groups (E1, E2, and E4),and open trays with splinted impression copings (OTSC) served as a control group. The control group was compared to the impressions of the coded healing abutments by using a standardized measurement protocol. Impressions were made for each group (n=18) and poured with vacuum mixed (100 g powder/20 mL water) Type IV dental stone. The vertical discrepancy (Z axis) between 2 prefabricated passively fitting titanium reference frameworks and the platforms of the implant replicas was measured with an optical comparator applying the 1 screw test. Data were analyzed with Kruskal-Wallis and post-hoc Mann-Whitney U tests, as well as the Wilcoxon signed-rank tests. The Bonferroni correction was used to account for multiple comparisons. The significance level (α) used in a given set of tests was equal to .05 divided by the number of tests performed in that set.
RESULTS:
The median vertical discrepancy of each coded healing abutment impression group was higher than the corresponding median of the control group (OTSC) for every combination of angulation and position. Kruskal-Wallis tests indicated a statistically significant difference (P<.001) between groups for each angulation/position combination. All post hoc Mann-Whitney U tests indicated statistically significant differences (all P≤.002) between OTSC and the other groups. Differences between the angulations and positions were not statistically significant when accounting for multiple comparisons.
CONCLUSIONS:
The implant definitive casts fabricated from the coded healing abutment impressions were found to be less accurate than those fabricated from the open tray with splinted impression copings technique for restoring 2 paired (10 or 30 degrees) convergent internal connection implants with nonengaging screw-retained splinted 2-unit implant restorations. Accuracy of fit was not influenced by the implant angulation or position for either impression technique or by the Encode healing abutment height for the Encode impression technique.
Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.
PMID:
23929370
[PubMed - in process]
So much for Robocast . . .
LCM

 

[Dali k]

Hi,
I understand that this is a study about the old way of doing encode cases by placing the analog in a plaster model by biomet. But what about the other way encode empowered labs are doing it now? I mean by rematching the healing cap virtualy and from there getting the implant position in the model and designing the abutment, crown and the model all at once virtually? are there any studies about this?

 

[BobCDT]

I have milled 3i certain compatible zirconia custom abutments , but as a sample . I wouldn't risk selling it . Are you guys having any cracked zirconia abutments ? Do you use them often , or mostly zirc over titanium bases ?

We stopped making zirconia CA's a few years ago due to too many broken abutments. Now hybrids only, much better results.