Forums
New posts
Search forums
What's new
New posts
Latest activity
Articles
Members
Current visitors
Log in
Register
What's new
Search
Search
Search titles only
New posts
Search forums
Menu
Log in
Register
Install the app
Install
Forums
Community discussion
Implants
Inclusive.... or exclusive? GW rant!
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Reply to thread
Message
<blockquote data-quote="prosthotech" data-source="post: 119649" data-attributes="member: 5409"><p>I own my own lab. We fabricate implant prosthetics for doctors around the country. Our specialty is full mouth implant reconstruction. Try using all-zirconia abutments opposing one another in the second molar region and tell me how it goes for you. Also, the all-zirconia abutments we have used are either prefabricated by the manufacturer or milled by Glidewell, as we have an agreement with them. We no longer use these outside of the esthetic zone.</p><p></p><p>How many of your cases have you personally delivered and followed for over 5 years? I may have an advantage in this regard, since I place the implant and take the records, then my lab fabricates the prosthetics to my precise specifications. I have been involved in placing and restoring thousands of implants, and lecture with material support from HiOssen, Implant Direct, Zest Anchors, GC America, and Bisco. I am the director of Modern Implant Institute and of the HiOssen Basic and Intermediate Implant courses and have seen enough problems with abutment design and inappropriate material selection to form an opinion that most dental technicians are not current with the literature. While I trust that your abutments are functional in vitro, it is often an entirely different world once the prosthetics are in full function for several years.</p><p></p><p>We have found that the all-zirconia abutments fail due to stress concentration at the angled areas of the connection, even snapping off in Morse tapered connections. Try to remove a cold welded piece of zirconia from inside of a Morse tapered connection, and I'm sure you will never use all-zirconia abutments in the molar region again. I really wanted these abutments to work, since we could use Nobel Rondo or ZirPress direct to a prefab zirconia abutment and make them with amazing shades that were very translucent. Moral of the story: support your posterior and angled zirconia abutments with titanium.</p><p></p><p>For dentists and patients who want to have zirconia for esthetic reasons, we will design the abutment in 3Shape, mill it on our BruxZir mill or Amann Girrbach Motion 2, and bond in the appropriate prefabricated titanium sleeve using Panavia. My short response to the original question was to use the longest possible sleeve, 6 mm, assuming it fits within the design envelope. The longer sleeve is difficult to debond, and transmits the bending forces deeper into the zirconia portion. Whenever possible, our screw retained zirconia or zirpress to zirconia crowns use a 6 mm sleeve.</p><p></p><p>I think you misunderstood my "all zirconia abutments" to mean that any zirconia abutment will break. Replace that with "all-zirconia abutments" or "full zirconia abutments," and I think you will have less of a problem disagreeing with my statement and the scientific literature.</p><p></p><p>My only problem with zirconia to titanium abutments, is that it adds extra labor and cost for minimal esthetic gain. If you are worried about titanium showing through a thin area, just bond composite opaquer with an appropriate metal primer to the mesio-facial aspects of the abutment you are trying to mask. If you want to get fancy, grind in a little relief in those surfaces, and the opaque will be flush with the rest of the abutment walls. Shofu makes an excellent, super opaque material that works well in these circumstances, keyed to the Vita Classic shades.</p><p></p><p>By the way, although I'm a vegetarian, I'm not fond of kale, especially on Fridays.</p></blockquote><p></p>
[QUOTE="prosthotech, post: 119649, member: 5409"] I own my own lab. We fabricate implant prosthetics for doctors around the country. Our specialty is full mouth implant reconstruction. Try using all-zirconia abutments opposing one another in the second molar region and tell me how it goes for you. Also, the all-zirconia abutments we have used are either prefabricated by the manufacturer or milled by Glidewell, as we have an agreement with them. We no longer use these outside of the esthetic zone. How many of your cases have you personally delivered and followed for over 5 years? I may have an advantage in this regard, since I place the implant and take the records, then my lab fabricates the prosthetics to my precise specifications. I have been involved in placing and restoring thousands of implants, and lecture with material support from HiOssen, Implant Direct, Zest Anchors, GC America, and Bisco. I am the director of Modern Implant Institute and of the HiOssen Basic and Intermediate Implant courses and have seen enough problems with abutment design and inappropriate material selection to form an opinion that most dental technicians are not current with the literature. While I trust that your abutments are functional in vitro, it is often an entirely different world once the prosthetics are in full function for several years. We have found that the all-zirconia abutments fail due to stress concentration at the angled areas of the connection, even snapping off in Morse tapered connections. Try to remove a cold welded piece of zirconia from inside of a Morse tapered connection, and I'm sure you will never use all-zirconia abutments in the molar region again. I really wanted these abutments to work, since we could use Nobel Rondo or ZirPress direct to a prefab zirconia abutment and make them with amazing shades that were very translucent. Moral of the story: support your posterior and angled zirconia abutments with titanium. For dentists and patients who want to have zirconia for esthetic reasons, we will design the abutment in 3Shape, mill it on our BruxZir mill or Amann Girrbach Motion 2, and bond in the appropriate prefabricated titanium sleeve using Panavia. My short response to the original question was to use the longest possible sleeve, 6 mm, assuming it fits within the design envelope. The longer sleeve is difficult to debond, and transmits the bending forces deeper into the zirconia portion. Whenever possible, our screw retained zirconia or zirpress to zirconia crowns use a 6 mm sleeve. I think you misunderstood my "all zirconia abutments" to mean that any zirconia abutment will break. Replace that with "all-zirconia abutments" or "full zirconia abutments," and I think you will have less of a problem disagreeing with my statement and the scientific literature. My only problem with zirconia to titanium abutments, is that it adds extra labor and cost for minimal esthetic gain. If you are worried about titanium showing through a thin area, just bond composite opaquer with an appropriate metal primer to the mesio-facial aspects of the abutment you are trying to mask. If you want to get fancy, grind in a little relief in those surfaces, and the opaque will be flush with the rest of the abutment walls. Shofu makes an excellent, super opaque material that works well in these circumstances, keyed to the Vita Classic shades. By the way, although I'm a vegetarian, I'm not fond of kale, especially on Fridays. [/QUOTE]
Insert quotes…
Verification
Who makes the popular shade guide?
Post reply
Forums
Community discussion
Implants
Inclusive.... or exclusive? GW rant!
Top
Bottom