Sameer Puri D.D.S. By now you have heard about the ability to create abutments with the CEREC 4.2 software. You can design the entire abutment and crown digitally. No models needed with the digital workflow that Sirona has created in the sense that all data is captured digitally and then milled to the specifications designed on the screen.
One potential problem that users will run into when creating their own custom abutments is designating the proper scanning device in the Administration Phase. When you are in the Administration Phase and you indicate to the software that you want to create a custom abutment, you have two choices that you must decide between to let the software know how you are actually scanning in the mouth. The two scanning options that are available are either a TiBase or a ScanPost. As you can see from the photo below, the difference is essentially the size of the scanning devices and how they are used in the mouth.
A TiBase is the actual abutment that will be screwed into the implant onto which either the zirconia or Emax abutment will be placed. You can watch videos on the abutment creation process HERE
The TiBase was originally introduced and intended to be used on top of a model and not intraorally. It's small size meant that at times you had to figure out a way to get the tissue out of the way because the tissue would cover the TiBase completely, making the scanning in the mouth more difficult.
With the release of the 4.2 software, Sirona also released the ScanPost. The ScanPost is meant for intraoral scanning only. You do not put the milled abutment on top of the ScanPost. The difference between it and the TiBase? Essentially the ScanPost is taller. If there is tissue in the way, the ScanPost elevates the plastic ScanBody so that the CEREC can read it easily. After scanning, the ScanPost is removed from the mouth and the TiBase is placed for the final restoration.
This is where it can get tricky. Look at the clinical case below on the two implants. If you indicate the wrong scanning device, the software essentially puts the implants in the jaw in the wrong space. It is doubtful that the implants were placed as deep as you see on the virtual model resulting in a poor proposal. This is simply the user indicating that a ScanPost was used in the Administration Phase instead of a TiBase. This results in the software burying the implants.
So when doing abutments, be sure that you indicate the proper device used for scanning otherwise you will spend unnecessary time designing the restorations.
