Posted October 12, 2016
……. a Bentley! Wait.. do you think I was going to say something cheesy like “My Two Front Teeth?” Its like you don’t know me anymore! Lol! Here is an immediate case where we ended up using the Telio CAD bridge block to shape the tissue rather than two individual abutment blocks. #8/9 mobile from an injury, fractured posts. Extracted and got a Digital Guide. Drew 4 vials for PRF.
Smooth surgery, ended up using the non discontinued drill extender from Implant Direct. Now we have the extra long drills. Mixed PRF with DFDBA and ended up going with a flipper as one of the two Legacy Implants was a spinner.
http://www.Digitalenamel.tvPatient returned in 6 months to uncover the implants. Note the flat profile from non immediate temporization. We now have to create that and hopefully grow some papillae. Used the guide to help locate the implants and the DEKA CO2 to at least start the process of finding my cover screws.
After the initial uncovery of the implants I then switch to a dry carbide Chamfer. Patterson Part Number 465-7227 by Mesinger. I find I can shape papillae a little more precise than the laser, but I don’t want to ding my implant.
I sandblasted some stock freebie abutments for Legacy 3s and did some prep in the mouth. That same carbide does a great job on titanium. As you may know the Telio CAD abutment block is meant for a single tooth, and yes, I could have milled out two, but it was easier to just mill them both out in the bridge block. I milled this with carbides and would not do that again as we end up with a bunch of sprue. Next time I would just mill slower with a diamond. Used the bridge setting on CEREC and just chose two abutments.
Just a little composite glaze. Yeah I am too supra gingival on the abutments but this guy had such a low lip line I had a hard time retracting his lips to get the shot. One stop shop with Zoom to bleach up his teeth.
Here he is at 3 weeks and note the gingival architecture we formed! Due to the implant position we opted for Emax abutments and crowns rather than screw retained.
Again, saved by a low lip line. The thickness of the abutments pulled his gingiva down. I am hoping for some rebound but thats him smiling as big as he could without anesthesia, so I am sure that margin won’t show.
