One day visit: some thoughts about procedures.
A certain number of procedures are required in order to achieve full data and items on the ‘one day visit’ concept, on a daily dentistry basis.
The accuracy on data acquisition based on CBCT and digital impression: planning for digital stent, custom abutment and provisional were provided by inhouse equipment.
The PET has been executed having in mind endodontic, surgical, and prostethic concept.
Endodontic: removal of inner part (internal canal wall and contents) and possible apex removal. Thinning of inner shield wall.
Prosthetic: shoulder prepare of 2/3 mm from gingival margin and trying to be respectful of anatomy and deciding about spaces.(a big dilemma…)
Surgical: maintaning the root part to remove, thick enough, so that it won’t break during extraction and if some area are still connected to the PET, thicker shield will break easily with no damage to the PET itself.
The technology of shield prepare is then completed by the use of Densah drill: on picture #4 the sinus membrane is easily dislocated by their use: implant apex screwed on bone below membrane enhances the primary stability required for ‘immediate loading’ (although the provisional is not in occlusion). The mesial and distal wall allowed an intial torque over 50N, required for immediate load osteointegration success. (see BIC# picture)
Still on picture #4 an interesting ‘Densah effect’: the change of inner surface quality: from rough initial one to smooth final one. Could that be beneficial for healing phase?
The abutment, one time custom, allows two define to major accomplishment:
-One time healing concept.
-Phisiologic healing with an elliptic prosthetic plattform and relocation of prostetic margin in a superficial area with easier and reliable cement removal.
Skill may be required to place implant in the range area together with the abutment and provisional. (some digital items can be used to improve predictability)
It is now possible to have abutment and crown in a post production way, using digital technology,possibly inhouse
These experiences about the ‘on day visit concept’ on daily dentistry basis, will be shared on international Versah Meeting (OWS) on January 12-14 2017 in Orlando. http://ows.versah.com/