Anterior Gingival emergent profile

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sonlab

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What is the best way to get adequate emergent profile of the soft tissue for #9 implant if the Doc sends impression of soft tissue emergent profile shaped only by the healing abutement?

Thanks
 
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sonlab

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Any issues with the Doc complaining that the abutment is causing the gingivae in situ to blanch too much? Or that the buccal bulge of the abutment is too subgingival?
 
Car 54

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I forget what is the rule of thumb is, if the tissue is still blanched after ~5-7 minutes, then it needs to be re-contoured?

I tend to split the difference. I lightly adjust the soft tissue with a football diamond, then create an emergence that pushes against the tissue
a bit, and will let the interproximal push the tissue a little more, crown emergence also. Interproximal tissue seems to be more forgiving also helping to close those spaces.
The Dr needs to realize if they aren't willing to create a custom healing collar/abutment, it makes it harder for us to anticipate.
 
rlhhds

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Any issues with the Doc complaining that the abutment is causing the gingivae in situ to blanch too much? Or that the buccal bulge of the abutment is too subgingival?
Once in awhile we have that situation. There are times that the patients tissue does not want to conform. Then we will discuss with the dr the best course of action to remedy the situation.
 
doug

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This is why the doctor needs to be proactive with healing abutments.
 
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sonlab

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Just finished #7 and #9 , impression straight off of regular healing abutements- I contoured gingival mask to give me ideal contours and designed gingival margins all the way to tip of gingival margin- in situ it fit exact-
May not have to make provisional implant crown in select cases- especially if patient has low lip line
 
doug

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Yes, it's their burden to shape the tissue. I'm tired of being the guy who is expected to make their work easy and then blamed when the whole thing goes to sh*t
 
Affinity

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You cant cook a steak dinner with ground chuck. If the tissue isnt managed from the get go, your going to get what profile is there. Most good Drs will pay attention to the blood flow and make sure its not too impinged too much, sometimes its not a problem, it depends on how deep the implant is also. Im done trying to make excuses for my final product when someone else is making excuses for poor placement or tissue management, or placing the wrong implant or manufacturer for the situation.
 
RDA

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With the update to Galway, we are experiencing a problem with the not being able to mark the tissue area to detect the emergence profile. The tissue area actually disappears, and just leaves the abutment showing. Any ideas on how to correct this? Our support has not been able to figure it out.
 
Davor RDT

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Ask for x-ray of implant site , doesn't matter if it's healing cap or impression coping on the x-ray . If there are photos showing soft tissue , identify soft tissue bio type .
At this point you will know weather implant is sub crestal or not and somewhat have a loose idea how much to reduce from soft tissue model to re-contour the tissue with either provisional crown or a custom healing abutment . Taking it to final is possible but .... it might have to be adjusted chair-side if blanching persists after 5 minutes . Still a shot in the dark .
But if you have to go to final what can you do .
 
Davor RDT

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With the update to Galway, we are experiencing a problem with the not being able to mark the tissue area to detect the emergence profile. The tissue area actually disappears, and just leaves the abutment showing. Any ideas on how to correct this? Our support has not been able to figure it out.
When you scan soft tissue trim away most of it leaving only small amount of scanned stone for merging purpose . I found this helped me not to loose gingival scan or have issues loading and merging it .And I have been having to do it manually with add/reduce tool . Very frustrating but exocad still choice .
 
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LarryRDC

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With the update to Galway, we are experiencing a problem with the not being able to mark the tissue area to detect the emergence profile. The tissue area actually disappears, and just leaves the abutment showing. Any ideas on how to correct this? Our support has not been able to figure it out.
If you're doing a separate tissue scan, leave it on and scan it as a solid model. (and set it up with no separate tissue scan) You can remove the tissue when scanning the scan body if you need to verify that its seated. Saves scanning time as well skipping that option.
 
RDA

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If you're doing a separate tissue scan, leave it on and scan it as a solid model. (and set it up with no separate tissue scan) You can remove the tissue when scanning the scan body if you need to verify that its seated. Saves scanning time as well skipping that option.
Our usual scan method is to leave the soft tissue in place on the model, and not have a separate tissue scan, and it is still eliminating the tissue area during the emergence profile design. This has only been an recent issue in the last couple of months.
 

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