Zirconia screw retained bridge

Brett Hansen CDT

Brett Hansen CDT

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So I got this case yesterday...7,8, & 9...astra 3.0 implants...patient is 19...needs case done before next friday morning so he can go back to college. Doctor wants to do screw retained bridge if possible. Astra does not make abutments for screw retained prostheses. I am going to do a Zir bridge on this one. My plan is to make 3 Atlantis Ti custom abutments and then have a Zir bridge, milled by Diadem, cemented over top of them. I am going to wax the case up today and scan the models for the abutments. Are there any other approaches to this case that may offer the doctor a screw retained option?
 
TheLabGuy

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I'm confused, it isn't screw-retained if you're putting a cementable zir bridge over the top of your titanium implants. In addition, astra has an internal hex on some of it's implants, can't have screw retained on an internal hex implants, they will never draw the same. However, Astra does have Cresco implants, is this what they were? If so, I'm sure a hybrid scenario could be achieved with a good milling center.
 
DMC

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Three non-engaging Ti-Temp abutments....cement the Zirconia substructure to Ti interfaces after you finish your porc. Now you have screw-retained with only Ti showing on bottom of interface. Disappears after screwing.


Same procedure as Single units...FDA approved for 3M Lava and many others...
I thought we already went over this?? Been there, done that.
 
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Brett Hansen CDT

Brett Hansen CDT

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Cresco won't work with this implant diameter. Scott, I like your idea alot. I am not sure if they make non-engaging temp abutments for the 3.0 platform yet.
 
DMC

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Well, that wouldn't stop me from trying.

I'd remove the hex. LOL

Implants Direct or Attachments International make any Astra stuff?

I have employees order this stuff. I haven't ordered implant parts myself in years.

Don't listen to me. LOL
 
Brett Hansen CDT

Brett Hansen CDT

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Scott, I will definitely try your idea in the future. It seems the most cost effective way to go for a screw retained prosthesis. I am going to scan the model now for Au-Hued custom abutments. I pulled a clear stint over the temps that the patient liked. I will spray it with cad/cam spray and scan it like a wax-up for the abutment positioning.
Ginder1.jpg Ginder2.jpg Ginder3.jpg
 
Brett Hansen CDT

Brett Hansen CDT

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We finished this case yesterday. I ended up shipping a waxup of the bridge to Diadem and they used their 3 Shape to scan and mill it out of Zir. It fit great. Our ceramist then layered the porcelain on the entire facial and insical. We left the lingual in Zirconia. This patient is an 19 year old male. I wish the implant at #7 wasn't placed right in the embrasure between #7 and #8, but we weren't involved in the implant placement. Here are the pics:
1000001594.jpg 1000001593.jpg 1000001592.jpg 1000001591.jpg
 
shane williams

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I'm pretty sure that Astra now offers screw retained custom abutments. You using Dental Wings to scan? We do, and after you finished scanning the case you send the file to Atlantis via web-order and in the items section under materials you can select screw retained abutments. So when they design they do a full contour design with a cut-back. Then you can stack or press directly to abutments for screw retained prosthesis. This is of course the abutments are placed correctly and the screw hole isn't coming out the incisal or facial.
 
Brett Hansen CDT

Brett Hansen CDT

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They do Shane, but I don't think they can do screw retained bridges. The implants were placed so the access holes would have been on the lingual. I haven't done one of their screw retained crown abutments yet...what are your thoughts on them?
 
shane williams

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You're right they don't do screw retained bridges, I was just saying they coulda been singles but screw retained. We actually just did a case the other day. Not bad as long as the design is made for support. We've done some in the past using Etkon for Straumann abutments. Found that pressing them turns out really nice. We use the E-max Zirpress ingots, good results
 
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lia

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I thougt that Atlantis does only single abutments, they are all screw retained , than you have to make a bridge on top of the abutments. Am I right?
But if you use Lava , dental wings or 3 shape, do they send you back a finished product or just the file, that they design and you mill out bridges or single units. Is that how all the scanners work? Can anybody who is strong in scanning give an advice, please.
 
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