Custom abutment and implant site optimization.

107 Rating(s).


Posted on By armando ponzi In Digital Scanning & CAD/CAM

The use of digital planning,PET, surgical stent, Densah drill and digital custom abutment may improve the implant site to a better optimization.
All phase of case presented (#26 initial case on the side)have been completed inhouse using digital technology.
We should better discuss and understand about prosthetic platform dimension and if esthetic on molar area needs to be achieved as expression of better structural result and ultimately better function.
Armando

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custom abutment

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15 Comments

Armando; Outstanding!!! Thanks for sharing. My biggest issue is with digitally designing a molar CUSTOM healing abutment to protect any graft or gap for optimal healing immediately after implant placement. This also would allow to maintain the soft tissue form for the final restoration. Is their a protocol that you use to accomplish this? thanks again Mo


Reply

Mo, thanks for kind words. It is an issue, you are right! I do that on a team approach with Stefano. Software (but also analogic system) don't shows a complete data pattern expecially on the marginal gingiva area (as you can see on first digital picture). So, some skills are required about margin abutment position. Healing around a custom 1A1T is IMO, a possible and viable way to achieve a '1 day visit' and a '1 time healing'. Armando


Reply

Ciao Armando

You have elevated the surgical/digital planning/ and hard and soft tissue manipulation to an art form.

IMO Beautiful

Rocco


Reply

Beautiful case Armando! would you consider screw-mentation to avoid de-bonding issues due to limited abutment height available for retention? maybe adding some retentive features?
Always enjoy your cases, regards,

Yiannis


Reply

Yannis, thanks for your words. Yes you are right that is a good viable option. I believe though that abutment should be integrated into implant and possibly never removed. This is why I personally prefer titanium abutment rather then T-base and Zirconia. Some retention could be added, I agree. The digital offers the unique possibility of getting back to drawings, modify it and send back to production without changing the other parts. So, in case of decementation I will consider that possibility, that is viable and easy enough digitally. Thanks for your comment. Armando


Reply

Rocco, you are firstly a great friend, so thanks for your compliments but also a great clinician so your words are very valuable to me. Looking forward meeting you in NY. Armando


Reply

Armando, your case convinced me finally that there is a new paradigm on molar area.
I can`t stop to admire a beautiful result and the steps of the procedure.
Best regards
Snjezana


Reply

Snjezana, thanks for your words. We all admire your surgical skills but also the incredible ability of taking ideas and merge them into daily practice. I personally love that. Hope you are coming to NY,are you? Armando


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Thank you, Armando. It means a lot. Imagine our days without trying some new improvement or without sharing our ideas, success and disappointment. And not asking ourselves why something happens.
NY: Unfortunately no, but two of my students are coming (already very excited:).
Cordiali saluti
Snjezana


Reply

Snjezana, well, I am sure that there will be other future occasion. I suggest you to look at www.versah.com: there will be the first world congress on Densah drill and I'm sure an incredible opportunity to share experiences on these drills. Armando


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January 12-14th, I have already set my vacation in Florida!
Snjezana


Reply

Great Armando! This is a perfect example of Biology plus ideal abutment design.
Simply nice!
Regards
Jorge


Reply

Jorge, I quite agree with your vision. Looking forward to your lecture in NY. Warm regards. Armando


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Armando. Amazingly precise work start to finish. Nobody does it better! Thank you for sharing. Best wishes. Chuck


Reply

Chuk, thanks for your words my friend. I believe that all of us are adding starting on different perspective. Mine is not surgical but prosthetical, so accuracy is the main issue on this type of procedure. Looking forward meeting you in NY. Armando


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