Has anyone made an implant crown under an existing cast rpd?

A

a3dl

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He lost tooth #29 which was the tooth supporting the RPD and had an implant placed. I have done crowns on natural teeth to fit an existing RPD but was not sure if it is possible to do so with an implant crown.

Any suggstions? 2 stage process? 1st fab abutment and have dr tryin and pick up w rpd to make crown 2nd go?
 
rkm rdt

rkm rdt

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He lost tooth #29 which was the tooth supporting the RPD and had an implant placed. I have done crowns on natural teeth to fit an existing RPD but was not sure if it is possible to do so with an implant crown.

Any suggstions? 2 stage process? 1st fab abutment and have dr tryin and pick up w rpd to make crown 2nd go?
What about a locator?
 
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a3dl

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PT doesnt want a new rpd at this time
 
rkm rdt

rkm rdt

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PT doesnt want a new rpd at this time
right, so why not use a locator instead of an abutment and add a denture tooth to the rpd?
I'm going on your description . can you post any pics?
 
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a3dl

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I do not have case yet. Dr asking what they need to provide. I instructed to give master 1 implant impression. 1 impression of partial seated (preop). And send rpd. I will scan all and merge data. will have to retro down partial to implant impression to fit check. Hopefully it works out lol
 
sidesh0wb0b

sidesh0wb0b

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He lost tooth #29 which was the tooth supporting the RPD and had an implant placed. I have done crowns on natural teeth to fit an existing RPD but was not sure if it is possible to do so with an implant crown.

Any suggstions? 2 stage process? 1st fab abutment and have dr tryin and pick up w rpd to make crown 2nd go?
what kind of crown?
also yes, i make these all the time. generally screw retained.
 
user name

user name

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Id use a Ti base, or what ever you want for an abutment. Prep it if needed and scan like it was a normal tooth. Design and mill in wax, verify contours, tweek the design and mill in Zr.

My 'model free' Dr hit me with one a while back. Scan both sides of the partial, merge the scans, then fit to the iTero scan. All thanks to @2thm8kr it was a success.

20200117_151144.jpg
 
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a3dl

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Yes I was thinking ti base screw retained. Ok thanks for confirmation. Yall the best
 
rkm rdt

rkm rdt

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I would want to know the condition of the rpd.
.does it still fit like the day it was made?
why was the 29 lost in the first place?
.if it was due to a poorly fitting partial that torqued it like a crow bar then an abutment and crown would not be my first choice.
 
lcmlabforum

lcmlabforum

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I would want to know if the tooth is the terminal abutment for a distal extension
RPD. Hopefully there is another abutment to the distal so this is a bound saddle instead.
There would be so much involved in getting the right height of contours to disengage,
etc in a distal extension for it to fit and function the same way and the way it should
to recreate as surveyed implant crown.
Really, I would have considered an UCLA cast to just for the right rest seat and
guideplane considerations. Otherwise, wax to ideal and press something like an emax
crown that can be luted to the Ti-base or other prefab abutment.
And the clinician needs to physiologically adjust the interfaces .
Like RKM said, what was the condition of the RPD - if it needs a reline for distal extension
tissue support, making the crown fit the partial would not solve that problem at all
and the patient would likely tell once he wears it or when he eats to say it does
not fit right.
Might be so much easier to add a tooth to the partial, and clinically pick up a Locator or Equator
abutment.
Good luck,
LCM
 
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