Zigging and Zagging

 

When I learned implants ages ago, I was always taught to look at the adjacent roots and to plan my implant parallel to them.  Which makes sense, you certainly don’t want to run into an adjacent tooth.  But as a GP that always bugged me as I would place these nice, lined up implants, yet would be faced with a restorative problem due to the fact that, although my implant may be in the “right position”, my abutment wasn’t.  Well, not anymore.  What I like to do is get my implant at least 1.5mm away from the adjacent teeth roots, then concentrate on the CONTACTS of the adjacent teeth.  To do that with any degree of accuracy you need CEREC.

 

 

After getting my CEREC proposal and taking the .ssi file into Galielos, I can then plan exactly where I need to be.  I had to go back and forth until I had just the right amount of room for the implant, but have my abutment be equip-distant from the adjacent teeth contacts.

 

 

 

 

Tissue was punched, note the tag on the buccal.  When I am right at 2mm, I don’t have a problem leaving tissue tags as if I was to remove them, I would end up with less tissue in the end.

 

 

So looking at the angulation of the implant, normally a wells deserved WTF would be expected.  But placing the implant in line with the other roots would give me a “leaning” crown not in line with the occlusal forces:

 

 

 

Here you can see that the abutment is centered in the space and we have a crown that more or less is in line with the arch:

 

 

Here is how the case progressed.