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paulg100
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OK have this case at the minute which is proving to be a bit of a challenge for various reasons, so thought id try and get some ideas on this..
1st problem is that to maintain tissue forms, we need to leave the custom abutments and temps in situ during fabrication of the prosthetics, plus its not possible to laser back the tissue to get clear margins to take a conventional imp over the abutments, as again this would disrupt the soft tissue contour.
So the only technique im aware of is to make thimble pick up copings on the abutments before intra oral placement. Then pop the copings on and take an impression over the top.
I then cast resin dies into the copings whilst in the imp, then a conventional stone model around it which ends with this..
I then recovered the copings from the imp and waxed frames on to these and pressed in MO Emax.
Then finished ceramic work and ended with this:
Now i knew the shade needed to be pretty translucent so i mixed in about 30% Trans Neutral into the dentine, couldn't do to much due to the opaque frames which needed to be opaque to cover the metal abutments. I also had problems getting enough separation between the teeth due to the placement of the connectors, so at try-in..
No where near translucent enough, and needed more separation between the teeth as suspected.
Just look at the damn translucency of those centrals, i hate these cases, how to make teeth look this translucent with an opaque frame underneath !?!
So this is what I'm doing now, managed to get the abutments out to make up some more thimble copings to press. Pressed these in Emax HO which i can stain and then wax frames to go over these and press in LT or even HT.
This is where the problems are starting, as i do not have an accurate model of the abutments to fit the HO copings to and theres no way i wanna do all the work to go over the top of these if I'm not 100% sure they fully seat and that the margins are correct.
So the questions is.. Anyone know of any other techniques to create an accurate working model of implant abutments when you don't have the abutments?
I thought one way is that maybe i could have adjusted the abutments when i had the analog model at the start, then screwed these in and duped the model in silicone. Although i don't know if this would be accurate enough??
Also maybe someone has some ideas on how to go about making bridge work look this translucent whilst still masking metal abutments?
It would have been allot easier with zirconia abutments as i could have stained these, then just pressed an complete LT or HT frame over the top without worrying about the masking issues, but client did not want to use these due to the bedding in and re-torque issues, and they don't make the two piece ones with metal insert for ankylos yet.
Thanks in advance for any thoughts...
1st problem is that to maintain tissue forms, we need to leave the custom abutments and temps in situ during fabrication of the prosthetics, plus its not possible to laser back the tissue to get clear margins to take a conventional imp over the abutments, as again this would disrupt the soft tissue contour.
So the only technique im aware of is to make thimble pick up copings on the abutments before intra oral placement. Then pop the copings on and take an impression over the top.
I then cast resin dies into the copings whilst in the imp, then a conventional stone model around it which ends with this..
I then recovered the copings from the imp and waxed frames on to these and pressed in MO Emax.
Then finished ceramic work and ended with this:
Now i knew the shade needed to be pretty translucent so i mixed in about 30% Trans Neutral into the dentine, couldn't do to much due to the opaque frames which needed to be opaque to cover the metal abutments. I also had problems getting enough separation between the teeth due to the placement of the connectors, so at try-in..
No where near translucent enough, and needed more separation between the teeth as suspected.
Just look at the damn translucency of those centrals, i hate these cases, how to make teeth look this translucent with an opaque frame underneath !?!
So this is what I'm doing now, managed to get the abutments out to make up some more thimble copings to press. Pressed these in Emax HO which i can stain and then wax frames to go over these and press in LT or even HT.
This is where the problems are starting, as i do not have an accurate model of the abutments to fit the HO copings to and theres no way i wanna do all the work to go over the top of these if I'm not 100% sure they fully seat and that the margins are correct.
So the questions is.. Anyone know of any other techniques to create an accurate working model of implant abutments when you don't have the abutments?
I thought one way is that maybe i could have adjusted the abutments when i had the analog model at the start, then screwed these in and duped the model in silicone. Although i don't know if this would be accurate enough??
Also maybe someone has some ideas on how to go about making bridge work look this translucent whilst still masking metal abutments?
It would have been allot easier with zirconia abutments as i could have stained these, then just pressed an complete LT or HT frame over the top without worrying about the masking issues, but client did not want to use these due to the bedding in and re-torque issues, and they don't make the two piece ones with metal insert for ankylos yet.
Thanks in advance for any thoughts...
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