Soft Gingival Tissue

[ParkwayDental]

We have been using a soft gingival tissue we use on our models when doing crowns on implant abutments. It works great for when I am designing custom abutments, but when it is time to do a crown when we go to seat the crown the tissue replica is consistently bouncing. It has a spring effect to it. We have dealed with this forever but giving it some thought lately is there anything out there that is better? I cannot name off hand what kind we use I'll have to get back on that one.

We have actually take some denture acrylic and we have been using this. We tried it on a bridge with 3 custom abutments. Custom abutments on 2, 4, and 6. We are bridging 2-6 as well. Designing the custom abutments with the hard acrylic went great and once we got the abutments milled they would not seat because we don't have that slight flex of tissue like we would with the soft tissue replica. I make my margins sub-gingival 1mm deep on the buccal, .75mm on the mesial and buccal, and .5mm on the lingual.

We had to adapt the hard acrylic around the custom abutments but personally I don't feel comfortable do it like this. After we adapted the tissue to the abutments, I milled a 5 FCZ bridge and it fit like a glove it was easier to adapt to the hard acrylic tissue we made due to it not having the bounce back like the soft tissue replica we were using.

I am trying to get an idea if y'all think the hard acrylic is a good idea, or if there is something better that will solve our issues.

In advance any help will be greatly appreciated.

 

[Rick Sonntag]

Have you tried Zhermack Rigid? It's the hardest PVS I've seen yet, easily trimmable with a diamond, carbide, or scalpel. I like to cut them in 1/2 toward the lingual for easier removal and abutment seating verification.

Rick

 

[ParkwayDental]

I have not tried it. Will have to test it out.

 

[doug]

I agree with Rick. That material is great.

 

[JSnyder85]

I like the gingifast elastic made by zhermack as well. Also we always allow for 1mm of bounce on all our implant crowns. No matter what material you use your always going to have minimal bounce. Also, are you contouring your soft tissue at all?

 

[paulg100]

"No matter what material you use your always going to have minimal bounce"

thats why your better off not using soft tissue models unless you really have to.



way more accurate.

 

[PCDL]

More accurate? I like soft tissue so I can anticipate my tissue impingement on abutments, and properly contour my sulcus. With a hard cast, once you modify it, your stuck. I like to slightly displace the soft tissue, or in some cases, drastically impinge on it. The ST will alert me to a problem I may run into on final insertion.

 

[paulg100]

i prefer to relieve with a small rosehead bur to the exact amount i require, or the exact amount requested by the doc.

0.5 of plaster reliefe gives me 0.5 of tissue impingment.

with springy soft tissue i never really had the foggiest idea how much i was impinging the tissue by.

"The ST will alert me to a problem I may run into on final insertion." I have to rely on my brain for that, dang!

"Have you tried Zhermack Rigid? It's the hardest PVS I've seen yet, easily trimmable with a diamond, carbide, or scalpel."

might take a look at that at some point though.

 

[JohnWilson]

More accurate? I like soft tissue so I can anticipate my tissue impingement on abutments, and properly contour my sulcus. With a hard cast, once you modify it, your stuck. I like to slightly displace the soft tissue, or in some cases, drastically impinge on it. The ST will alert me to a problem I may run into on final insertion.

This is exactly why the technique was developed. We do the same thing and we use Zhermacks material as well,

 

[paulg100]

from the discription of the Zhermack Rigid it sounds like it behaves more like stone than tissue, so its hard to see how that bares any resemblance to how tissue will compress or behave in the mouth. Maybe for a hard biotype??

if that's the case its hard to see any real term benefit of using it (scanning requirements and commercial factors aside),but guess ill have to order some and see.

 

[JohnWilson]

from the discription of the Zhermack Rigid it sounds like it behaves more like stone than tissue, so its hard to see how that bares any resemblance to how tissue will compress or behave in the mouth. Maybe for a hard biotype??

if that's the case its hard to see any real term benefit of using it (scanning requirements and commercial factors aside),but guess ill have to order some and see.

It does flex unlike stone and while its no where near as soft as some PVS it fits our need well. I am experimenting with some CLEAR PVS material for my Full ARCH CASES that we doing BARS for, its very handy to be able to see if through the material to verify if the jig/abutments are seated.

 

[Hary]

Hi, for those who use acrylic you can try the pink IMPAK-PF with the cold cure liquid for Impak...

 

[EJADA]

I have tried many. I use zermack rigid also. By far the best. Trims easily minimal bounce back.

 

[lcmlabforum]

A talented tech recommended Flexacryl soft - same last name as one of the members here in Burleson, Texas.
If you don't need to make custom impression posts with Duralay, etc, it works just fine.
LCM

 

[actittle]

A talented tech recommended Flexacryl soft - same last name as one of the members here in Burleson, Texas.
If you don't need to make custom impression posts with Duralay, etc, it works just fine.
LCM

The flexacryl worked well but we now use Zhermack Rigid, it carves easier and it scans better.

 

[lcmlabforum]

Ah . . . so . . . wanted to give Rick the credit. I like the ability to mold Flexacryl with the little brushes they
no longer come with.
LCM