Off Kilter: Immediate Legacy Molar aka Why Tho?

What’s wrong with me? I keep saying to myself with Cerec Guide 2 why would I ever do another non guided case?  Well, chalk it up to being stubborn,but here is a non guided immediate molar that was a little more palatal than I would like.  But that being said a perfect indication for a screw retained Emax crown.  #2 initial endo done by yours truly, retreated still a lot of pain. Offered to refer to endo, patient had #3 done by me wanted another implant. Extracted implant, immediate only had a 5.2 so no 7mm like I liked grafted with DFDBA and Cytoplast collagen.

 

Its pretty obvious that I am too palatal.  Here is a restorative conundrum!  We have the access hole in an area of high wear, the cusp tip.  I know many would go cemented here.  But we also have a buccal cantilever.  Which due to the high occlusal forces could loosen the abutment screw and the abutment and or break the screw itself!  So I opted to go screw retained.

Here is the final. Not the most beautiful screw access, but I doubt any one will see it besides me.  If things loosen up, I have easy access!