Ti based implant crowns

[Davor RDT]

Hey Techs . What y-tzp types of Zirconia is acceptable for use on ti base supported implant crowns . Full zirconia crowns to be percise ? Despite haveing seen folks use the type 5 (weaker but really translucent) I still question what is best practice in this case .

Thanks for any help

 

[AnAppleaDay]

Most cases, you're better off using HT+ type materials (>1000mpa).
They have decent translucency without being too translucent (showing the metal beneath).

 

[Contraluz]

Hey Techs . What y-tzp types of Zirconia is acceptable for use on ti base supported implant crowns . Full zirconia crowns to be percise ? Despite haveing seen folks use the type 5 (weaker but really translucent) I still question what is best practice in this case .

Thanks for any help

Every case is different, but in general we use a more translucent material for individual restorations, like ZirCad Multi MT, Argen ST Multilayer, Sagemax Multi etc.

But for multi units, we mostly use a higher strength material, like Argen HT+, Whitepeaks etc,

As for the metal shining through, in my experience, the cement takes pretty much care of that. We use Multilink Hybrid HOO.

 

[rkm rdt]

not really a fan of ti bases and shag carpets.

 

[Davor RDT]

Most cases, you're better off using HT+ type materials (>1000mpa).
They have decent translucency without being too translucent (showing the metal beneath).

This is my thoughts kind of . Often the really translucent materials just look gray and lacking in Dentine to enamel transition once in mouth .

 

[Davor RDT]

Every case is different, but in general we use a more translucent material for individual restorations, like ZirCad Multi MT, Argen ST Multilayer, Sagemax Multi etc.

But for multi units, we mostly use a higher strength material, like Argen HT+, Whitepeaks etc,

As for the metal shining through, in my experience, the cement takes pretty much care of that. We use Multilink Hybrid HOO.

Thank you . Good thinking . Do you find loss of chroma in mouth with more translucent materials ?

 

[rkm rdt]

Thank you . Good thinking . Do you find loss of chroma in mouth with more translucent materials ?

not if I use custom abutments.
I can control the thickness of the zirconia which gives me better control over value along with a white opacious cement.

 

[TheLabGuy]

I hate ti-bases, the cheap half-@ss way of doing implants in my opinion (no support, no retention, no emergence, etc...). I haven't done a ti-base in 10 years and do about 600 implants/year. Educate your Docs, custom titanium abutments are what should go on implants.

 

[Davor RDT]

I hate ti-bases, the cheap half-@ss way of doing implants in my opinion (no support, no retention, no emergence, etc...). I haven't done a ti-base in 10 years and do about 600 implants/year. Educate your Docs, custom titanium abutments are what should go on implants.

Thanks Lab guy . I agree with you . Market got used to something it should not have and now it is requested. Funny how that is .....

 

[Jack_the_dentureman]

I hate ti-bases, the cheap half-@ss way of doing implants in my opinion (no support, no retention, no emergence, etc...). I haven't done a ti-base in 10 years and do about 600 implants/year. Educate your Docs, custom titanium abutments are what should go on implants.

i don't quite understand how ti base doesn't have a emergence profile ?
I do a lot of screwed work on tibase and custom titanium mill abutments also.
With most systems I don't see a profile, retention or support problems and none of the cowns were breaking.
I really like the way in which I model a part of the sub gingival and its transition into tooth made of zirconium.
zirconium also has a much better effect on periodontium than titanium.
I think you are terribly generalizing the topic. If I don't know something here and am doing some nonsense, please correct it

 

[RCKSTR]

I do 5-10 FCZ screw retained crowns on ti bases per week. I don't think I've designed or ordered a custom abutment in 3 years. They work well, and the emergence profile can be created in the restoration.

 

[LarryRDC]

Whatever works for ya, personally I like ti-bases and don't feel they are of lesser quality at all....I have been using ti-bases for 5 years and can create custom emergence profiles on all of the crown bottoms of the ZI tops. ( using Exocad) Hardly any problems at all with color, breakage or de-bonding. Pretty much do all of them screw retained.. single, bridges, and hybrids. Some (ti-bases) are designed better than others....There's a lot to choose from out there. Choose the right one for the job and they work fine IMHO.

 

[TheLabGuy]

Ti-bases are lesser quality in my lab, they rank right up there with mini-implants which I detest with a passion for definitive purposes. We will just have to agree to disagree but I do a ton of lithium disilicate and maybe that's where my angst is with ti-bases. When you create something similar to what a crown prep is, the retention, emergence and contours are much more appeasing.

 

[Jack_the_dentureman]

Sounds like belief, not proven.
There is no problem with a job well done
and debonding with tibase so i dont understand the argument with step milling for better crown seat.
I omit the problem with a thin gingival phenotype, color blocking translucency and aesthetics.
I will just add that if you do work on the ti-base,screw retained vs screw retained custom milled frame, you have the advantage that in the event of an error, however the framework is not passively seat, the tibase will be dislodged, instead of the implant extending out.

I definitely do not want to argue which is better, but to point out that it depends on the case.

To make ti-base worse in this discussion is to misunderstand and generalize.
It's also easy for me to say that something is bad because I don't like to work on it, but that doesn't mean that it's not intended to solve a problem that I don't see.

The effectiveness, survivability and various benefits of ti-base and diffrent custom abutments are not objectionable.
I understand the discussion of one-piece implants that there are problems with them (used in special cases, not by choice) but to compare them to the ti-base. sorry but no.

 

[Tayebdental]

i do ti bases and I get nothing but good comments from my dentists

 

[Sda36]

Also like Ti bases, as said earlier by others, emergence is all designed to be full Zr, most bio compatible and can be added to if the need arises easily. Can't do that with custom Ti abutments. Never had a Ti base fracture or de-bond out of tons done. Custom milled may be bigger but not stronger as the weakest link in the chain is at the implant interface and cross- sectionally they are the same. Ti bases now come in different gingival heights which makes them far more like custom abutments for deeper cases. I agree that before these came out, you could face problems potentially with bone impingement with bone level implants using Ti bases but now with different heights this can be easily avoided.

 

[Sda36]

Only times where we do custom abutments is to straighten out path of insertion to create better proximal contours if adjacent teeth are tipped or path of insertion is rather wonky.

 

[Sda36]

As far as Ti and Zr over top and which Zr, go with strength in mind as well as translucency. We use White opacifiying agents in the pre- sintered state (Changs Opaque White, Origin White 2 for example. Just paint on internally bearing in mind a little goes a long way.)
If you ever have to de-bond for a shade adjustment or adding a contact you'll be much less likely to encounter a cracked restoration during the de-bonding process. Low and slow is the rule but sometimes its risky and more so with lithium disilicate from my perspective.

 

[Contraluz]

Thank you . Good thinking . Do you find loss of chroma in mouth with more translucent materials ?

Not necessarily. But I have had the situation where I had too much translucency in the incisal halve. I always can add chroma, but masking excessive translucency is almost impossible .

 

[Contraluz]

i do ti bases and I get nothing but good comments from my dentists

If I can use a ti-base, I use it.

If I have to deal with an uneven emergence profile or funky placed implant, I prefer a custom designed abutment. Be it TruAbutment, Nobel Procera, Straumann, Atlantis or Vulcan. I have worked with all of them and they all work well. We design them in-house.