Implant Planning Question

[digimiller]

I have a case that is bone level straumann, RC 37, NC 36, this is my first time coming across doing work digitally, I usually use a UCLA and build up on top... The Dr is asking for screw retained... The implant is deep... Two options is TI Base or Custom Abutment... Can i do this case where the emergence starts 3-4 mm deep if I use a Ti Base and cement on top? the 37 has 2mm deep on mesial and 4mm deep on distal where implant starts.

 

[rkm rdt]

nc for a 36?

 

[digimiller]

36 Stram BL 3.3 x 10
37 Stram BL 4.1 x 8

 

[TheLabGuy]

I stay away from Ti-bases because they aren't tall enough. Now you're saying it's really deep too...no thanks, do a Custom Titanium abutment and make crown w/screw access hole crown and cement that on your properly supported custom titanium abutment.

 

[Contraluz]

I stay away from Ti-bases because they aren't tall enough. Now you're saying it's really deep too...no thanks, do a Custom Titanium abutment and make crown w/screw access hole crown and cement that on your properly supported custom titanium abutment.

I agree on the custom abutment! In many cases it is the best solution. More so in a casa as mentioned above.

However, if the case permits, Straumann is one of the few OEM that offers different gingiva (cuff) and chimney hight!

Open implants also offers different gingiva hight and a chimney that is plenty tall.

 

[rkm rdt]

Can you still use a multi layer on a tI base?

 

[Sda36]

I agree on the custom abutment! In many cases it is the best solution. More so in a casa as mentioned above.

However, if the case permits, Straumann is one of the few OEM that offers different gingiva (cuff) and chimney hight!

Open implants also offers different gingiva hight and a chimney that is plenty tall.

Yes, 3 mm cuff height extension, measure but you should be fine if deep. We generally contour ( expand) soft tissue for a whole host of implant placements unless oral surgeon was planning a mushroom factory. 3mm gets you sleekly out of alot of placements. Or even 2mm. 1 mm can get you into some problems for sure as you can engage bone issues near placement. They are bone level afertall and you need to be aware of that. So grateful they Finally came out with extended gingival extensions.They follow same profile as healing caps and would usually expand soft tissue around 1- 1.5mm sub gingival level to at gingival height level. Much like contour soft tissue via Atlantis for an example. Hope this helps

 

[TheLabGuy]

Can you still use a multi layer on a tI base?

Sure, we used e.max for years if not decades now ya old f@rt, multilayer is still twice as strong as e.max.

 

[digimiller]

Anyone mill their own custom abutments? Titanium? Tips/advice?

 

[TheLabGuy]

Anyone mill their own custom abutments? Titanium? Tips/advice?

Tough to get into that game when you have TruAbutment and others out there. Plus, if you did an honest cost analysis of what you'd have to produce to just break even, you'd have to do quite a few everyday. Now if you were milling bars then that might change the analysis quite a bit but still...then dealing with the FDA's BS on top of that...profit margin just wasn't there for us...yet!!!

 

[LarryRDC]

There's a lot more options available now with ti bases.. .Open Implants has up to 3mm gingival heights with chimney heights adjustable up to 8/10 mm's. that would be pretty deep! DESS has different gingival heights too.
Straumann has a 3mm GH with 3.5mm or 5.5mm chimney heights if your client want OEM, just make sure you charge for the extra cost of OEM
Let your docs know what's available and let them know how much $, then let them choose.

 

[molarmaker]

Would love to read more of this type post

 

[digimiller]

Dr did choose OEM custom abutments, price not an issue. Will be milling them myself and I am planning to design with a crown and bridge workflow with exocad and put a screw hole after. First time designing both, (custom abutment as well as screw retained implant). Any suggestions will be great

 

[CWilliams]

Dr did choose OEM custom abutments, price not an issue. Will be milling them myself and I am planning to design with a crown and bridge workflow with exocad and put a screw hole after. First time designing both, (custom abutment as well as screw retained implant). Any suggestions will be great

I process to finish my abutments first and then scan it in and design my crown etc. Probably takes me a little bit longer but I never do both at the same time, for fit purposes.