Pimp My Implant: CEREC Guide Immediate Implant with Custom Abutment

Here is another completed case. Patient came in with #5 fractured, so we planned for an immediate implant with CEREC Guide.

Older case, so there is the Nobel Keys being used with the ID drills.  My new ones are still taking forever and a day, but I’m working on it. I may end up switching production companies if I don’t get them soon.

Implant placed, big socket and not a ton of stability, so we packed bone over it with a membrane and sutured.  Later we replaced the healing cap with a healing abutment.

4 months later.  We used a 5mm healing abutment. And you can see that we are at the top of it with the tissue, so we need to figure out what type of abutment we can use.

Fixture level impression.  You can see how deep the implant is, you can also see that the implant may have drifted a bit into the socket.

You can’t use the el cheapo freebie abutment for a number of reasons.  First, its just way too short, no ferrule.  Second, the 2mm collar would put thecement line just way too deep under the gums.

I had a stock abutment in my drawer with a 5mm collar.  In this case the cement margin would be more cervical.  But we still lack the ferrule that we would need for resistance and retention.

Aahh, much better.  Custom titanium from Custom Direct!  Lots of ferrule and only slightly subgingival margin.

Torqued down nice at 30 Ncm.  Sponge placed in access.

Final.  We should get some gingival fill on the mesial as I used a 5.7 mm healing abutment and the gums got a little compressed.