Ti based implant crowns

[Brett Hansen CDT]

I have been begging Atlantis to make a non engaging custom abutment for years. ;(

 

[Toothman19]

Next time you do one, can take a screen shot of where the option is on the order form?

Once you submit the .stl file you fill our the implant system, platform size, then engaging or non engaging, and anodized or not

 

[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.

It's a sad day when you have to quote yourself but I'm WRONG folks. In my defense and as I wipe the egg off my face I can say I wasn't wrong for why I thought and stated above. Therefore, I'm changing my mind over ti-bases. I've done some research and caught a lecture by Dr. Tomas Linkevicius from Lithuania. A well published Prosthodontist and he uses ti-bases exclusively. Why you ask?...because by using polished zirconia below the tissue it has stopped over 80% of any bone loss or perio-implantist. Matter of fact, using polished zirconia below the gingiva line actually regrew bone and tissue. Sounds crazy but it's true, seen many dehissence implants regenerate bone growth and we're saved without any surgical intervention. Furthermore, the stability of an implant comes from the implant placement and those do's/dont's versus the ti-bases. Tissue and bone love polished zirconia, pictures and x-rays and the research isn't lieing. Has nothing to do with a titanium supported crown and when compared to polished zirconia, the polished zirconia wins hands down in a screw-retained environment. So, i was wrong.

 

[doug]

Welcome home, Rob!

 

[doug]

Lecture Dr Tomas Linkevicius

 

[TheLabGuy]

Lecture Dr Tomas Linkevicius

Yep, that's it, very informative!!! The 4mm vertical tissue height is huge on implant placement and the way the cortical bone really grows back with polished zirconia sold me. Really crazy to see how a glazed surface actually inhibited any regeneration and health of implant.

 

[Tayebdental]

One of the reasons many dentists prefer ti bases and screw retained implants in general is due to the fact that many cement retained implants fail due to the lack of proper removal of excess cement that left behind and logged deep surrounding the implant causing the growth of bacteria and subsequent implant failing.

In screw retained implants procedure and sense many dentists now a days are restoring with implants , this cement issue is eliminated with longevity and good successful results and the ease of removal if needed.

Edit, Pardon me if somebody mentioned this before I did not read the whole thing

 

[TheLabGuy]

One of the reasons many dentists prefer ti bases and screw retained implants in general is due to the fact that many cement retained implants fail due to the lack of proper removal of excess cement that left behind and logged deep surrounding the implant causing the growth of bacteria and subsequent implant failing.

In screw retained implants procedure and sense many dentists now a days are restoring with implants , this cement issue is eliminated with longevity and good successful results and the ease of removal if needed.

That's true, but you can still have perio-implantist and significant bone loss if you don't use polished zirconia below the gingival crest. Titanium and any glazed restoration prevented the epithelial tissue from attaching itself to the implant, in where polished zirconia did create growth in that biological environment. Granted, the surgeon has to do his/her part in making sure there is 4mm vertical tissue height and selecting the correct implant (conus/connical vs. internal hex vs. subcrestal) for stability. As a tech, I thought we created the stability...that's on the surgeon. The lab creates the biology to promote bone/tissue growth...and that is by polished zirconia.

 

[Tayebdental]

That's true, but you can still have perio-implantist and significant bone loss if you don't use polished zirconia below the gingival crest. Titanium and any glazed restoration prevented the epithelial tissue from attaching itself to the implant, in where polished zirconia did create growth in that biological environment. Granted, the surgeon has to do his/her part in making sure there is 4mm vertical tissue height and selecting the correct implant (conus/connical vs. internal hex vs. subcrestal) for stability. As a tech, I thought we created the stability...that's on the surgeon. The lab creates the biology to promote bone/tissue growth...and that is by polished zirconia.

That’s true, and how many times I have to asked a dentist or an oral surgeon to use the proper conical healing cap /analog and proper height to give me the room to design a functioning implant.
What I see many times is a tubular narrow implant access hole.

 

[Toothman19]

This is a fascinating topic. I've always loved using ti bases but always felt the zirconia was a little unsupported and I've gone the screwmentable route (custom abutment w/ zirconia on top with access hole). So is there an issue with support with a ti base on the big molar implant crowns?

 

[Andrew Priddy]

It's a sad day when you have to quote yourself

it is a great topic, and an important one.. and to think, if you hadn't of posted this?

but always felt the zirconia was a little unsupported and I've gone the screwmentable route

one of my main reasons for switching to exocad.. also have your video for future reference, good stuff thank you.
also, if you haven't used TRU abutment bases, im a fan.. I've seen many base to Zir failures, mainly for lack of "bondable" surface area..
bases that were "pushed" on the market and lacked sufficient height/support

 

[LarryRDC]

This is a fascinating topic. I've always loved using ti bases but always felt the zirconia was a little unsupported and I've gone the screwmentable route (custom abutment w/ zirconia on top with access hole). So is there an issue with support with a ti base on the big molar implant crowns?

I don't have any issues with large molars on ti bases. You have use sytems that have the correct or adjustable "chimney" heights. Starumann, Open Implants, and Mist(Imagine) are a few. Some have different gingival heights as well. The new Elos component look interesting as well. Many options...

 

[TheLabGuy]

This is a fascinating topic. I've always loved using ti bases but always felt the zirconia was a little unsupported and I've gone the screwmentable route (custom abutment w/ zirconia on top with access hole). So is there an issue with support with a ti base on the big molar implant crowns?

Support comes from implant placement...I use to think the support came from us as well hence my dislike for ti-bases (and always making a titanium custom abutment)...but to get that polished zirconia below the gingival crest you would have to use a zirconia hybrid or a ti-based implant. Sure, you could make an argument about how some of those ti-bases are short with some manufacturers but the research doesn't show it makes any difference...the surgeon creates the support, the lab creates the healthy biology and the general dentist is the quarterback making sure the play happens correctly.

 

[Toothman19]

That's true, but you can still have perio-implantist and significant bone loss if you don't use polished zirconia below the gingival crest. Titanium and any glazed restoration prevented the epithelial tissue from attaching itself to the implant, in where polished zirconia did create growth in that biological environment. Granted, the surgeon has to do his/her part in making sure there is 4mm vertical tissue height and selecting the correct implant (conus/connical vs. internal hex vs. subcrestal) for stability. As a tech, I thought we created the stability...that's on the surgeon. The lab creates the biology to promote bone/tissue growth...and that is by polished zirconia.

Would this polished rule also apply zirconia crowns with sub g margins?

 

[TheLabGuy]

Would this polished rule also apply zirconia crowns with sub g margins?

Yes it would

 

[Pronto]

We just got an email this morning from Argen. They have updated their files and will have a dme availible this week. Hybrid non engaging will we added as well as several new items.

 

[HonestAbe]

and will have a dme availible this week

Sorry noob question here, but what is a DME?

 

[TheLabGuy]

Sorry noob question here, but what is a DME?

Post in thread 'Definition of dme' https://dentallabnetwork.com/forums/threads/definition-of-dme.25309/post-240460