Stock Implant Abutment Prepping and Other Things

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MLeeDT

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Hello. My questions are rather newbish so pardon my amateur-status.. please bare with me. I was just wondering if anyone can gimme some insight on the following things..

I fully understand how to prep a single unit implant abutment but when it comes to multi-abutment cases, I don't get the rules in parallelism.

Instead of explaining my problem in just words, I made a really quick illustration of my problem to help (Yes, I made it in 1 minute in Paint).

8mMFpu.jpg

The 3 colored lines show the different possible ways to prep the abutments, yes? Now when doing singles, the way I learned it was that I should usually prep the abutments so that it's parallel to the adjacent teeth and their contact points, which is simple enough. But when it comes to multi-unit abutments and their different angles, I'm not sure how to approach it.

The green line being parallel to the adjacent tooth's contact point seems sensible, but it'll make the abutments extremely thin and non-retentive.

However, both the red and blue lines seem to make sense, albeit it doesn't line up well with the adjacent tooth's contact and might cause some issues with insertion, yes?

Also if red and blue are correct, then do I have to apply both angles or just 1 of them? In other words, do I match the distal of AB2 to AB1 as well as the mesial of AB1 to AB2 or just 1 of them -- and additionally, why/why not?

What is the overall proper procedure?


And I have another question about implant/analog/abutment types. As a technician, I'm not exposed to many actual implants but rather their analogs. I have some trouble picking out the right abutments. I can recognize Zimmer/Nobel Biocare analogs fairly easily, but I have a very difficult time recognizing other companies. I am aware of the website 'What Implant is That?" but that I believe is mostly used for doctors as it relates to implants only. Is there any other website or sources I can go to, to verify analog types? Preferably a source that has images of the platforms, flange type, whether it's a hex, trilobe, internal/external, etc etc.

Thank you all so very much if you actually even read this. I'd be grateful for any help!
 
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Mjr

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Hi mlee. You seem to have the right idea. Remember that stock abutments usually come in different angles and no just straight. The idea is pretty much the same as for a single unit. Just make sure you have a nice broad contact area on the adjacent tooth to prevent food packing. So I would go with green but buy a stock the Is more angled the other way so you are left with more it the stock abutment after trimming hope this makes sense. Regards


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rkm rdt

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You should be receiving a copy of the surgeons torque test/ osseointegration letter issued to your dr. This will indicate and verify the type of implant and platform size.
 
Car 54

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From my understanding, most angled abutment (at least the ones that I know of) are angled, designed to be angled labially lingually. So in this case, I would get the UCLA (castable) type of abutments and wax to move things distally as needed to maintain a nicer sized abutment, and maintain a path of insertion for both of them following the green line. That way you don't end up in fighting to get the wide and deep contacts all the way around.

You could also have them scanned and milled by Atlantis?

Also, I have the Drs send me a copy of the oral surgeons letter of what they used (as rkm also mentioned above),as sometimes there's instructions concerning what the lab needs to look out for (narrow occlusion, keep totally out of occlusion etc) If the Dr placed the implant, call them and find out the "make and model".

By the way, nice job with the Paint diagrams.
 
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MLeeDT

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I apologize everyone, I really meant to stress that I'm only an employee and I don't fully handle abutment selection and such. My employer usually picks out abutments and gives them to me to prep. I would try to ask for directions but he is difficult to have a conversation with. Anyhow, I believe he chooses stock abutments over milling/customizing for his own reasons such as to save time for rush cases, or to save money, or to avoid calling the doctor for minor adjustments. I understand it might not be completely textbook, but he is my employer so...

In this scenario.. as a technician not fully responsible with the abutment selection, what are my options in the preparation of the abutments? And also, I was asking for the analog references because I wanted to try and learn which abutments I could use for a case so that I could pick them out, and show to my employer that I'm willing to help out on the abutment decision making if he happens to not be around, which is a good portion of the day.

Hi mlee. You seem to have the right idea. Remember that stock abutments usually come in different angles and no just straight. The idea is pretty much the same as for a single unit. Just make sure you have a nice broad contact area on the adjacent tooth to prevent food packing. So I would go with green but buy a stock the Is more angled the other way so you are left with more it the stock abutment after trimming hope this makes sense. Regards


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Thank you Mjr for your response. Yes, I forgot that not all abutments are just straight. Your solution makes sense.

You should be receiving a copy of the surgeons torque test/ osseointegration letter issued to your dr. This will indicate and verify the type of implant and platform size.

Thank you rkm for the info. I never knew that that was the standard procedure to figuring out implant types between technician and dentist. My employer never seems to read any letters or anything.. he just seems to know what abutments to use just by looking at the transfer coping and analog for 98% of the cases, and that made me to believe that that was how it's done everywhere else.

From my understanding, most angled abutment (at least the ones that I know of) are angled, designed to be angled labially lingually. So in this case, I would get the UCLA (castable) type of abutments and wax to move things distally as needed to maintain a nicer sized abutment, and maintain a path of insertion for both of them following the green line. That way you don't end up in fighting to get the wide and deep contacts all the way around.

You could also have them scanned and milled by Atlantis?

Also, I have the Drs send me a copy of the oral surgeons letter of what they used (as rkm also mentioned above),as sometimes there's instructions concerning what the lab needs to look out for (narrow occlusion, keep totally out of occlusion etc) If the Dr placed the implant, call them and find out the "make and model".

By the way, nice job with the Paint diagrams.

Thank you Car 54 for your response. Oh yes, that sounds like an ideal solution and I have done that from time to time, but only via my employer's decision. We do some CAD/CAM as well but once again, my employer makes decisions on the abutment fabrication method.. same with the surgeon's letter.
 
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gallagerdental

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Good work on explaining your prob. Tho sounds like you're in an awkward spot. If I could suggest one thing, if you have the impression coping screws or waxing screws available to you place them on the model & mount on a surveyor prior to milling abuts. You can set the proper path & use that as a point of reference as you cut the abuts. This helps me from time to time. Good luck.


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