Here is a case that was a tough one. Patient had come in earlier with a deep bite and #9 fractured at the gum line. I knew I really had to sink this implant deep to get clearence for an abutment or simply the abutment screw head.
Whenever you are designing your .ssi files remember to pay attention to the CEJ. We want our implant to be 3-4mm below the CEJ to develop “runway” or proper emergence profile. If you do not draw that in your margin you will not have an accurate idea of where to place your platform.
I know I want stability and length so I went with a 16. I know my D2 on a standard long drill was 22, which would not be long enough for a 16mm so I measured it with an extender which give us 26mm minus 1mm for the key so a D2 of 25.
Designed and milled. Started with the 2.8 Implant Direct/Zimmer Key (look for it on the online store at IME) and then the 2.3. Note the position in the socket, right through the cingulum.
Implant placed. Note that even though we are about 2mm sub “socket” we still have ferrule and later I even had to reduce the occlusal of the abutment.
Implant placed, not the gap distance. Placed a TSV 3.5 scan post. We took a Bio-Copy Image before to help in design.
Just a shot demonstrating the difference between imaging the abutment and using a scan post. The scan post does not need a margin, but its really hard to read the margin on an abutment.
Here is the emax block. You can see that even with all the planning I still have the screw hole in the incisal edge! Its really just a matter of 1mm or so that make the difference.
Because we had to stack porcelain to correct for the access hole, we temporized the case for a week while the lab worked on it.
Back from the lab. I like to use the Implant Direct screw rather than the Ti-base screw. The Ti-base screw has a longer head. Note the tissue formation at just one week.
Here is our final. Screwed in at one week, the tissue is beginning to form. We may use this as the final. She has a deep bite so this should be in occlusion soon, will re eval at 4 months.