I Guess You Can Be Too Thin: Ti Base Show through Telio/Emax Legacy 2 Pilot Guide case

I always promised to show the good, and not so good cases so here is another “saved by a low biplane case” where the final restoration had some Ti Base show through.  As you use CEREC more and get to play with more materials I am finding that I have some “defaults”.  Screw retained crowns or Abutments and Crowns on big teeth like Molars? E Max definitely!  But I am finding on smaller teeth the translucency of E max, which has always been the reason why I love this material, shows too much of the Ti Base.  This patient had a loose post and core on #9 and lives in Vegas so she had it extracted and grafted then came to me.  I ended up using a pilot guide as this was a live surgery Patient for an Implant Direct class. You can see that due to the angulation of the planned Implant there is no way we could go with a screw retained restoration.

Although I don’t normally do this I went right through the gingiva rather than using a punch as I wanted to save as much tissue as I could. The bone was really soft we went with a 3.7 by 11.5 Legacy 2 implant and no other drills.

After placing the Implant I used my DEKA laser and shaped the tissue further with a carbide chamfer doing my best to avoid the papilla.  Places a scan post for a 3.5 TSV.

In retrospect I should have taken some off the mesial of #8 to make it wider. #9 is a bit more narrow.  Another problem is the amount of gray on #8.

I normally don’t do this but I used the same scan that I had at the time of surgery to make the Emax abutment and crown. This is an old patient of mine who moved to Vegas so I figured to save time I would have the abutment and crown ready for her.  You can see that the abutment is way too thin and the minimum thickness is showing through.  If I had to re do this case I would either go with a zirconia abutment and Empress CAD multi or even went with a one piece zirconia abutment like Atlantis that had no Ti base.   I tried the crown in with an opaque try in paste but you can see in the unretracted image that the crown looks too white.  But that being said the lip was low and the patient was happy. You live and learn!