#8 Immediate implant, custom healing abutment
Did this case today, Extracted #8, immediate implant placement with grafting and custom healing abutment. I really am enjoying this work flow. The final crown is ready to mill from my Omnicam Image today.
It takes about 18 min to mill Enamic and another 10 or so to cement it to Tibase. In this case I was doing implants and grafting on the lower left as this was done.
Nice presentation Robert! Curious what the preplanning depth from gingival margin to the implant is, and the height of the facial plate from the same landmark.
Mark
Great Job !
It will sure reduce the number of sessions and traumatization of the soft tissue and sure preservation of tissue esthetics. But for me as new cerec user i am so curious to know why you didn't do a provisional restoration as full crown? is it how the patient left ? do you consider the custom abutment as a custom healing abutments? It is just from an esthetic point of view and the patient acceptance ! Thank You !!!
Amazing job as always! The only minor change I would consider is to more aggressively under contour the healing abutment, especially around the papilla on the mesial. I try to avoid any tissue blanching when placing the healing abutment, which is slightly different than placing an abutment in a healed site. Just my 2 cents.
On 10/12/2016 at 8:50 am, Mark Stockwell said...Nice presentation Robert! Curious what the preplanning depth from gingival margin to the implant is, and the height of the facial plate from the same landmark.
Mark
3mm from gingival margin, had almost 3mm to facial plate
thanks!
On 10/12/2016 at 9:21 am, Elie Jomaa said... Great Job ! It will sure reduce the number of sessions and traumatization of the soft tissue and sure preservation of tissue esthetics. But for me as new cerec user i am so curious to know why you didn't do a provisional restoration as full crown? is it how the patient left ? do you consider the custom abutment as a custom healing abutments? It is just from an esthetic point of view and the patient acceptance ! Thank You !!!
I would have rather done a provisional, but in this case did not. Good initial fixation, but I felt due to occlusion and the amount of implant in native bone I was not comfortable. The healing abutment was actually a custom abutment with the chimney removed. Called it Emax and milled Enamic.
Pt left with an. Essix retainer. With all the old Pfm crowns it was a flipper or essix.
Thanks
On 10/12/2016 at 10:19 am, Daniel Butterman said...
Amazing job as always! The only minor change I would consider is to more aggressively under contour the healing abutment, especially around the papilla on the mesial. I try to avoid any tissue blanching when placing the healing abutment, which is slightly different than placing an abutment in a healed site. Just my 2 cents.
Dan,
thanks. Looking at the pic you are absolutely correct. I tried to undercontour the facial but did not enough and should have done more on the mesial. Even with the stock healing abutment on during milling of Enamic the tissue still collapsed a bit.
thanks for your 2 cents
