Fun Size: When you can’t use a Scan Post or a Ti-Base

Here is a tough case in which I tried to use CEREC Guide AND a CEREC Abutment and just did not have the room!  #25 fractured without a lot of ferrule, really tight “soon to be edentulous” space.  Did not even try to fit a small reference body.  In retrospect I could have temporized and went with a pilot guide.  But the end result was good.

Tooth removed, as you can see the socket kicked me to the distal, but I still ended up fairly centered with a 3.0 Legacy 3.

Sand blasted the abutment for scanning with the Omnicam as it hates anything shiny.  Note, use a little tape on the emergence profile of the abutment as you do not want to blast that.  We know rough stuff gets plaque.

Scanned up in CEREC and made a temp.  Could not get a decent PA, so I took a Pan.

As you may or may not know there is no Ti-base for a 3.0 Legacy 3, and you may also know that you need at least 600 microns of Emax or Zirconia as a framework around it.  You can see that we just do not have any room, even for a custom Zirconia abutment from Custom Direct (ID’s custom abutment and framework lab), so we had to go with Titanium.  But if we go with Titanium it will show through with the adjacent emax crowns.  …..What to do?….What to do?

Lucky for me I work with a great lab guy Jack from Level 3 Dental Studios.  He went on “the google” and found an opaquer used on Zirconia crowns and hybrids.  He was able to opaque out the Titanium and do an emax crown in InLab. This will replace my protocol of using an opaque UCLA abutment with these tight cases!