Implant crown design help

[rkm rdt]

LOL, I have nothing.

 

[sidesh0wb0b]

The patient is informed that an implant will avoid prepping the adjacent teeth . After going through the surgery and waiting time only to find out I'm getting a bridge because of poor placement, I'd be calling my lawyer.

valid assumptions, but they are just that. we dont know at all what the patient has or hasnt been informed of.

 

[rkm rdt]

True but it's safe to say he wasn't expecting a bridge.

It's also safe to say that there probably was no diagnostic wax up or surgical guide either.

 

[Hary]

This implant was placed way lingual and leaning towards lingual. tooth number 19 to be crowned on there. Wondering do I overlap that ridge to help the emergence profile line up with 20 and 18? Or do we...?Dr. usually likes to keep the stock abutments and use them but it will be left as a sliver so we'll try to push back buccally with custom.
Any help will be great. Especially from Sideshow Richard. View attachment 16803

I would do like RKM said screw retained and the lingual wall no porcelain only metal at least where my UCLA hole ...

 

[KentPWalton]

The patient is informed that an implant will avoid prepping the adjacent teeth . After going through the surgery and waiting time only to find out I'm getting a bridge because of poor placement, I'd be calling my lawyer.

How are you going to get in trouble for suggesting what the Dr. should do? He's the one that did the poor surgery, He's going to

be held responsible.


I agree with you that the patient was sold on the implant, but it was obviously poor treatment planning. The patient should have

been informed that they may not be eligible for the implant if all of the factors didn't add up. Or they may have to graft some bone

to be able to place the implant in the proper position. The doc should have used a guided surgery kit and some planning software in my opinion,

even though it's a single tooth but a difficult case. Hard to go wrong when you take the time and look out for the patient's best interest.

May cost the doc a little extra money up front, but will save him exponentially in cases like this that could get ugly in court later.

 

[RileyS]

So here's a question about minimum height needed in an abutment. I'll be cutting it off below the green which leaves little bit of extra room I feel. I know at my last lab we did a lot of screw retained FCZ crowns and the interfaces are always pretty short. anyways let me know you think

 

[pjd cdt]

I have a account that also uses implant direct. For this case I would do a custom abutment

 

[KentPWalton]

So here's a question about minimum height needed in an abutment. I'll be cutting it off below the green which leaves little bit of extra room I feel. I know at my last lab we did a lot of screw retained FCZ crowns and the interfaces are always pretty short. View attachment 16874 anyways let me know you think

I feel that you should do a custom abutment here. Sink the buccal margin 1mm since the patient obviously doesn't take care of their teeth with the gum disease going on there. You need as much metal support as you can get.

You don't want such a large piece of Zr in the mouth and so heavy. That's just my opinion though.

 

[Mohammad Khair]

Stock abutment must die hoomwahaha, one more vote for custom abutment here.

 

[TheLabGuy]

I would also do a custom abutment, but I've inquired into this years ago and there is no research out there that says you weaken the implant screw or cause any harm by having a short abutment. However, keep in mind proper porcelain support.

 

[rkm rdt]

I'd like to see the occlussal view , but I would make a fcz screw retained crown with an incisal 1/3rd cutback for porcelain .