Posted September 5, 2013
Here is another case and a constant reminder that I have no business doing implants non guided! When I lecture, I talk about the percentage of the time I do guided cases and I want it to be 100%, but also I think that if I said 100% people would think its not true. So every now and again I get the urge to try a case without a guide and I am never happy with my result. So here is a not so stellar case and how I got out of it. #2-4 bridge loose via peril. #14 was done guided with CEREC guide previously. Sorry not a lot of surgery shots, too bloody to keep!
http://www.Digitalenamel.tv#14 was an immediate molar with MFDBA grafting and a membrane.
About 4 months after the implants in 2 and 4. You can see the draw issue with the platform. Had used cover screws, switched out to Contour Healers to get a better soft tissue profile.
Much better tissue with the contour healers and yes, #15 is on the docket, he just wanted to get his implants done first.
You can see the issues the lab had to deal with. #2 was very subgingival and tipped medially. Also the lab had to find a common path of insertion with #4. Note the screw positions relative to the occlusal table.
In the mouth though everything looks business as usual. Nice amount of ferrule, good occlusal clearance. Slightly subgingival margins for esthetics. Torqued down well.
#14 has a decent emergence profile, definitely no “pumpkin on a stick” here!
Final bridge and I think we got some good contours and anatomy in spite of my wonky placement. It took me only 16 years of practicing dentistry to figure out the trick of placing floss under the bridge before cementing in the mouth to make it easier to remove cement from under the pontic!
