4-unit, 2-implant cement-retained bridge... Engaging or non-engaging abutments?

[Contraluz]

I'd rather not name names

Totally understand. I ask, because I have issues with one brand with loose screws and broken internal hexes. And, after asking around, it seems I am not the only one...

 

[user name]

Totally understand. I ask, because I have issues with one brand with loose screws and broken internal hexes. And, after asking around, it seems I am not the only one...

I dont know if this relates, but at least with Straumann, the screws for non-engaging are slightly stronger since they have potentially more load on them without the engaged part of the abutment. Just something to consider when modifying one.

 

[Contraluz]

the screws for non-engaging are slightly stronger

I have to admit, I was not aware of that. Makes sense, though. But, it doesn't relate to what I mentioned above (different company...)
;-)

 

[Jason D]

I leave one engaging and one with the hex removed.
Always a custom abutment.

What possible reason? Other than dental technician superstition....

 

[KentPWalton]

Rule of Thumb:

Engaging on all abutments for Cement retained prosthesis.

Non-Engaging on all abutments for Screw Retained prosthesis. (You can get away with one of them being engaging if your Dr requests)

Note: If you modify the connection of the abutment, you will void the manufacturer's warranty. There is no need to adjust the connection, the geometry is there for a reason. If you need a non-engaging part, purchase that separate part.

 

[rkm rdt]

Rule of Thumb:

Engaging on all abutments for Cement retained prosthesis.

Non-Engaging on all abutments for Screw Retained prosthesis. (You can get away with one of them being engaging if your Dr requests)

Note: If you modify the connection of the abutment, you will void the manufacturer's warranty. There is no need to adjust the connection, the geometry is there for a reason. If you need a non-engaging part, purchase that separate part.

Where do you order a non-engaging custom abutment?

 

[KentPWalton]

Where do you order a non-engaging custom abutment?

Non-engaging abutments will NOT be custom abutments that I'm aware of. You will need to purchase them from the implant manufacturer. They should provide them as a stock solution.

 

[rkm rdt]

Sorry but that's a compromise not a solution.

 

[Contraluz]

Sorry but that's a compromise not a solution.

Isn't most of what we do a compromise?

 

[rkm rdt]

Isn't most of what we do a compromise?

perhaps, but I still think a custom abutment is still a far better choice over modifying a non-engaging stock abutment.

If I make custom temps or healing caps, a stock abutment is a non starter.

 

[Contraluz]

If I make custom temps or healing caps, a stock abutment is a non starter.

I agree, if you talk about cement retained restorations. You definitely want to have a custom emergence profile.

However, on screw retained solutions, you can create your emergence profile in Zr, if needed. I also find custom abutments an overkill, for a single, screw retained restoration. For example, I like the Ti-base solutions Nobel and Straumann have, since they offer different cuff hight.

On occasions, I find myself using modified stock abutments, instead of ti-bases, in screw ret. cases. If you have multiple abutments, Ti-bases are pretty much your only solution. Since, as mentioned above, you can't get any non engaging custom abutments (I think, for obvious reasons).

 

[Sda36]

I agree, if you talk about cement retained restorations. You definitely want to have a custom emergence profile.

However, on screw retained solutions, you can create your emergence profile in Zr, if needed. I also find custom abutments an overkill, for a single, screw retained restoration. For example, I like the Ti-base solutions Nobel and Straumann have, since they offer different cuff hight.

On occasions, I find myself using modified stock abutments, instead of ti-bases, in screw ret. cases. If you have multiple abutments, Ti-bases are pretty much your only solution. Since, as mentioned above, you can't get any non engaging custom abutments (I think, for obvious reasons).

Still waiting for non-engaginging Ti bases from Struamann, near I hope, Nobel, who knows. Dess has good alternatives, that I know work perfectly, I always bounce off the Dr. 1st and explain the situation. Hey, if the premier implant names don't provide the sloution others will with equal warranty.

 

[Contraluz]

Dess has good alternatives

I use Dess on a regular base. I also like 'Open Implant,' too. Although, the later has limited offerings.

 

[DrG]

Still waiting for non-engaginging Ti bases from Struamann, near I hope, Nobel, who knows. Dess has good alternatives, that I know work perfectly, I always bounce off the Dr. 1st and explain the situation. Hey, if the premier implant names don't provide the sloution others will with equal warranty.

Straumann has a non-engaging Ti base for RC: Product ID 022.0111 . Medentika too.

 

[rkm rdt]

I agree, if you talk about cement retained restorations. You definitely want to have a custom emergence profile.

However, on screw retained solutions, you can create your emergence profile in Zr, if needed. I also find custom abutments an overkill, for a single, screw retained restoration. For example, I like the Ti-base solutions Nobel and Straumann have, since they offer different cuff hight.

On occasions, I find myself using modified stock abutments, instead of ti-bases, in screw ret. cases. If you have multiple abutments, Ti-bases are pretty much your only solution. Since, as mentioned above, you can't get any non engaging custom abutments (I think, for obvious reasons).

You have more options with singles, yes, but not with bridges. I would rather use 2 parallel custom abutments than modify 2 stocks. TI bases are only an option if the surgical gods have blessed you with ideal placements.
For singles, I stoppd using tI bases on bone levels .

 

[Contraluz]

TI bases are only an option if the surgical gods have blessed you with ideal placements.

Hence my comment:

Isn't most of what we do a compromise?

I am not arguing with you and in general, I agree with what you are saying.

 

[rkm rdt]

Hence my comment:



I am not arguing with you and in general, I agree with what you are saying.

It's all good.,we're on the same page brother.

 

[Brett Hansen CDT]

Straumann has a non-engaging Ti base for RC: Product ID 022.0111 . Medentika too.

I have used this part once on a screw retained bridge and the abutments would not retain the bridge. They are too small for anything but very short bridges where VDO is limited. I have done hundreds of screw retained implant cases using Atlantis' custom base and Straumann.s variobase....never had a crown debond except on that case.

 

[lcmlabforum]

You have more options with singles, yes, but not with bridges. I would rather use 2 parallel custom abutments than modify 2 stocks. TI bases are only an option if the surgical gods have blessed you with ideal placements.
For singles, I stoppd using tI bases on bone levels .

Can you share your reason for not using TiBases on Bone Level implants?
LCM

 

[KentPWalton]

You have more options with singles, yes, but not with bridges. I would rather use 2 parallel custom abutments than modify 2 stocks. TI bases are only an option if the surgical gods have blessed you with ideal placements.
For singles, I stoppd using tI bases on bone levels .

Why modify two stock abutments when you can purchase Non Engaging Ti bases that if cemented properly are perfectly passive in the interface? I don't get your argument here. They don't have to be parallel if the hex is non-engaging.