Posted April 8, 2014
We are all friends, you know me, I’m the “Implants Made Easy” guy , right? Well for some reason its been “Implants Made F^%$cking Hard” in my office lately! Immediate cases, edentulous cases, CEREC Guide up the Ying Yang. Everyone wants an immediate temp and wants it yesterday! And this falls into my lap! Too busy to treat, I took an alginate, a Galielos scan and sent the patient on her merry way! Ahh the luxury! Immediate implant #29, plenty of bone, nerve fairly far away. She wants a tooth ASAP, which I’m cool with that.
http://www.Digitalenamel.tvOne, very minor complication is her anterior loop of the mental foramen! Look at that bad boy! Extends past the canine. No worries she still has a ton of bone!
Got the guide back from Germany in 6 days. Used my handy dandy extraction tools. We will have these up on the site http://www.implantsmadeeasy.com, but give me some time. Just got the first shipment of my CEREC Guide handles which I need to get to those that pre-paid. And then about 50 pre-orders but once I get that down, I’ll put my stuff up. And, of course, they are all colored blue to match my eyes ;} Atraumatic extraction of #29 with my periosteal and periotomes.
Very smooth sailing. As always, place your pilot in the ostoetomy to measure the true depth and lean back to assess the angulation, check out the anterior loop in the PA!
Legacy 3 3.7 by 16! Awesome stability! Maybe a little close to the nerve for my comfort, but we are lingual so there is more bone there. Indexed to the lingual.
Right after placement, placed a scan post and imaged with the CEREC. Note my placement and the resultant screw hole! Designed using a TSV 3.5mm scan post in CEREC 4.2.
Tried in, again, note the screw hole position. Did not pay attention to the occlusion in the CEREC software and paid for it with a lot of grinding! carved the anatomy back.
So can I digress a bit? Check out the screw hole in the Galielos plan, the CEREC plan, and the final! I mean come on, how can that be more accurate? Planned, placed and final. There has been a lot of bad press from the old guard and just jealous types that say Guided is a bunch of horse pucky, but come on! To those nay sayers, this image happily gives you the one finger salute!
As always, I like to progressively torque my abutment screws, using the Implant Direct Legacy 3 screw not the Ti Base screw. I start at 20, wait a bit, then 25, and another bit, and then 30. Great stability even with an immediate!
Another interesting phenomenon with the Emax block, the translucency!! With screw retained PFMs I have the problem of always being too translucent with my composite in the access. In this case, I am too opaque with my composite! Who knew? Flow it ALC opaquer and .4 opaque A3 with a sponge in the access!
Final!! Its just killing me that I have some flash in my photo!! I want to get the patient back and re take the final. But again, you can see my ochre stain and access and if anything I could have done without the opaquer! If you are not doing Emax abutments and Screw retained crowns, Sh&*t or Get Off the Pot! This stuff is unreal!
