Issues with implant fits

[McTechnician]

We've recently had a few implant cases returned to us due to the restoration being open, but it has been fitting tight in lab on the models. We are struggling to find the issue and figured I'd turn to DLN to see if anyone has dealt with similar problems in the past. I'll try and provide as much info as I can about the situation but any direction to start digging for a solution would be great:

• Only been happening with 2 Dr.s specifically
• Restorations are tight on models but open in mouth
• Haven't had these issues with any standard crowns/models, only implants
• Haven't changed workflows or any materials in our process.
• Fit has been good for analogs and they are fully seated

We're not sure if its a scanning issue or something in our process. We've been told by Itero reps that the new Lumina scanner has had some small issues with implant fit, but at least one of the doctors is using the Element still. Considering nothing has really changed on our end, aside from recalibrating some of our machines we are at a loss for at which step in the process the issue is occuring.

 

[sidesh0wb0b]

We've recently had a few implant cases returned to us due to the restoration being open, but it has been fitting tight in lab on the models. We are struggling to find the issue and figured I'd turn to DLN to see if anyone has dealt with similar problems in the past. I'll try and provide as much info as I can about the situation but any direction to start digging for a solution would be great:

• Only been happening with 2 Dr.s specifically
• Restorations are tight on models but open in mouth
• Haven't had these issues with any standard crowns/models, only implants
• Haven't changed workflows or any materials in our process.
• Fit has been good for analogs and they are fully seated

We're not sure if its a scanning issue or something in our process. We've been told by Itero reps that the new Lumina scanner has had some small issues with implant fit, but at least one of the doctors is using the Element still. Considering nothing has really changed on our end, aside from recalibrating some of our machines we are at a loss for at which step in the process the issue is occuring.

i take it these are from i/o scans?
check the calibration on the printed models. print some test calibration cubes and measure. have the Dr take a PVS and an i/o scan on the next case, compare the stone model to i/o scan and printed model. lots of options here to troubleshoot, and the Lumina easily could be part of it (that is a whole new topic)

 

[McTechnician]

Yes, from IO scans. I'll have to print some calibration cubes when I get a chance, but all our other models have been working great so I'm not inclined to think the print accuracy is the problem. I hadn't thought of asking for an impression as well next time, that will probably be the best option to get all the info I need to trouble shoot it hopefully.

 

[grantoz]

i would check the way the do temps

 

[Cleo]

Implants can be tricky to seat because of the insertion angle between the implant and teeth contacts can be different. I had a doctor with the same problem so I went and watch his assistant seat it. Completely hogged off the contacts to get it to seat. Another doctor wanted a crown on a stock abutment with really deep implant. Tissue kept the abutment from seating and the doctor hacked up the crown thinking it was contacts. Tried to tell me I made it with 1mm open margins. I just remilled and showed him the difference. Point is I would check and see if you have some user error. Might be a clueless dr or assistant.