dry milling abutments in 4.5
I have been asked about this a lot, so I thought I would post a quick case...
In 4.5, you now have the ability to dry mill zirconia abutments with carbides (can wet mill with carbides too if you do not have the new mill). The advantages of this are going to be smaller sprue and time savings
Here is a case that I inherited. He came in with an implant placed on #8, and a crown prep on #9. He was wearing a cantilever temp as a provisional. He had a trauma at work and both #7 and 9 had RCT as well. Implant was a 3.3.Straumann Bone Level
My plan originally was to crown #7, Implant custom abutment and crown on #8, crown on #9 and do a composite on #10 to make more symmetric. He declined the composite on #10 or now because he didn't think it was necessary and was not too conscious of the esthetics.
I was mostly concerned with the symmetry of the centrals, so here is my original plans:
Here is what the design of the centrals and the dry milled custom abutment looks like:
and here is the final result:
Tremendous results as usual Mike. Was there a mandatory reason for you to choose zirconia over eMax for this case for the abutment?
Beautiful Mike.... it looks like you prepped 7 after seating or construction of the centrals... was that an advantage?
Mark
On 3/30/2017 at 8:55 am, Gregory Mark said...Beautiful result! You're My Hero!
I would probably use HT blocks. Gregory
Gregory--how would that work since you have different stump shades?
On 3/30/2017 at 9:32 am, Mike McKinley said...On 3/30/2017 at 8:55 am, Gregory Mark said...Beautiful result! You're My Hero!
I would probably use HT blocks. Gregory
Gregory--how would that work since you have different stump shades?
If you look at original pictures, adjacent teeth have a lot of enamel, that is why they are a little bit greyish. HT would be perfect here. The thichness of a crown more than 1mm would not interfere with final shade. Gregory
Let me answer some of the questions
- I did the centrals first because this was a highly difficult case and I felt it was important to get the symmetry and midline correct before moving on to the lateral. Once the centrals were done, the lateral was easy.
- I did provisionalize once to let the tissue heal slightly to the new level after pushing it a bit with the abutment and slight recontouring
- I thought about using HT on this case, but in the end decided against it because of ceramic thicknesses. To get the abutment in the correct position, the veneering structure was going to be quite thin on tooth #8... much different than tooth #9. So although the MT would resulted in slightly more brightness and opacity, it also allowed them to look the same. It would have been highly difficult to do this with the HT. The case is hard enough and you have to be predictable in the materials.
Very nice! Beautiful job. I agree MT pretty much the only eMax block I'd use in the anterior these days. I always found HT to be to grey.
Great result. I am always a bit hesitant to use Tibases with narrow implants, especially if the surrounding bone is tight. That said, based on the CBCT this looks like a perfect case for it.
Mike,
'very nice case.
is there any way to put your template into the omnicam to help design the crowns?
