Vanilla Ice: “White Metal” Immediate Implant Case with CEREC Guide

 

Here is an every day case that we face as GPs.  Patient breaks off a lateral, going on a vacation soon and has to look great.  We really did the whole “tag team” thing here, starting in CEREC for the ssi, back to Galileos, then CEREC again for the CEREC Guide and finally the CEREC “temp”.  Now one issue I have, being quite snobbish these days with custom abutments ;}), is that I need an abutment to temporize.  Yes I could do it with the Emax blocks, but that does take a lot of time and you do have to burn out the ti base, which I have heard from a few is tough.  There is a product called “White Metal” from Blue Sky Bio, which is a titanium opaquer.  So I gave it a go and I must say, its quite awesome!

 

 

Planned the case in Galileos.  One ting I love to do is turn off the model and check my implant relative to the crown.  We know our math, right?  3-4mm below the CEJ for emergence profile but no further than 5mm to grow a papilla.  Note also the pilot drill path which estimates where the screw access would go if this was a screw retained crown, so we know we will need an abutment and crown.

 

 

While CEREC was milling my guide, I removed the root with my IME Luxator kit and surgical kit. Should get some more soon, I know I have gotten a lot of requests.

 

 

 

Tight space, but I still used a 3.7 by 16mm Legacy 3.  The 3.0 would not have the stability I needed.  Note the fixture mount is an abutment and this patient has a high smile line and is esthetically conscious.  Plus is going on a vacation, so I needed to make a great temp, and cement it permanently.

 

 

But what to do?  Titanium is ugly and would certainly show through her thin tissue.  So I tried out the White Metal from Blue Sky (www.blueskybio.com).  First you cut the top off the Legacy 3 mount (if using the Legacy 4 you would just pop it off) Sand blast after trying in the mouth.  She had a deep bite, but I still did not have to prep.  Then use a light cured primer.

 

 

 

 

Apply the opaquer to just above the abutment margin.  Scanned in CEREC and milled a B1 Empress CAD Multi “temp”.  I use Emax for my day to day stuff and still have a ton of Empress in my drawer so I like these instead of dealing with the big ‘ol Telio CAD block.  But look at how well its masked!!  In the past I would use a stock Zirc abutment for my temp, then chuck it and went with a custom abutment for my final.  Not any more, I can save at least $120 per case using the stock abutment from ID!  Cemented with Multi-Link and will just prep it off at 6 months.