CEREC Decision - The Lesser of Two Evils

One of the big advantages that we have with the CEREC when restoring implants is the ability to have full control over the restorative component of the process. If we have input into the placement of the implant, then invariably the restorative component becomes exponentially easier. However, when the implant position is less than ideal, then no doubt the restorative component becomes challenging.

Take this case. Patient presented to the office with the implant already placed. My job is to now place the restoration. While the implant is in a good position, it’s not in an ideal position. Guided surgery was done but I don't know what protocol was used to determine the position of the implant. Had the implant been placed slightly more palatal, I would not be fighting the challenge of trying to keep the buccal wall of the abutment thick enough.

In addition, as you can see, if my margin is hidden and kept equigingival or subgingival, then I have a very thin wall on the facial of the abutment. If I thicken up the facial wall, then most likely we end up with a supragingival margin.

Obviously the amount of lip display will have a big impact on what we end up doing. But in this case, despite our technology, we will still end up with a somewhat compromised case.