Poorly aligned implant?

Poorly angled implant in too small an edentulous space

Sometimes a patient shows up for the restoration of their implant and everything is easy. The implant is placed just where I would hope it could go and the the stars seem aligned for me to fabricate a screw retained implant restoration... sometimes not so much.

For a lab to fabricate a screw retained implant the implant must be placed so that the eventual screw hole will exit through the occlusal the implant crown. It can't end up coming from the mesial, buccal or lingual. Now some implants allow the fabrication of angled screw channels that can facilitate using implants that are up to 30 degrees from ideal alignment. Still some implants can not be restored as a screw on implant crown, but instead are best restored using a custom angled abutment and a crown that is cemented onto this abutment.

Dentists contemplating restoring implants also must be aware of the proximal guide planes of adjacent teeth as well, since these dictate the possible path of insertion of the implant restoration and if these guide planes are in conflict with the path of insertion of the implant internal component, then a custom abutment usually works better than a screw retained implant crown.

Just this week a patient came in with an implant placed in a space that seemed too small for an implant restoration. When I showed my periodontist the radiograph he commented that the adjacent teeth may have drifted since the implant placement since the patient had waited a good long while after the uncovering to come in for my restoration. Whatever was the case I was able to trim both adjacent teeth a little bit in order to provide the space and the proximal alignment needed to fabricate my restoration using an angled abutment and a cement-able crown.

Implant #21 after adjusting the proximal contour of #20





from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/11/poorly-aligned-implant.html - http://lspindelnycdds.blogspot.com/

Comments

Post a Comment

Popular posts from this blog

Help! My Child is Terrified of the Dentist

Image
If you’re the parent of a young child, you know their brains are similar to sponges that soak up everything around them—especially in their first five years, which neuroscientists say is when they’ll do the most learning and developing in their entire life. At this formative time, your child may amaze you with what they notice: your facial expressions, the different tones of your voice, and your habits. If your habits include regular dental visits and an excellent oral hygiene routine, they’ll notice and want to emulate you. If you happen to feel anxious about your dental visits, or you groan when you’ve got to floss and brush, they may synchronize and feel your dread. This could lead to dental fears that stick with them for years—potentially a lifetime! Kids Can Be Courageous If you’re feeling guilty right now, go ahead and put that away as it won’t serve you or your little one. Everyone has some room for improvement, and Coastal Pediatric Dentistry® is here to help show you an...
Read more

Going for the Gold?

Image
On the left is the older allow, on the right the new one that my lab has chosen to use The cost of a penny weight of pure gold is currently $79.53. The cost of a penny weight of pure palladium is $130.6. It used to be that palladium was added instead of gold to the precious metals often used for pfms, but now laboratories are finding that palladium is no longer affordable. The lab that I am using has just changed the formulation of the metal it's using to one that has more gold than palladium. I really do not mind, but metals with more gold are softer and often easier for a dentist to accidentally polish off delicate margins. It is important when polishing "higher gold" formulations to exert less hand pressure when performing the final polishing of the crown's margins. Other wise there should be no problem with this change. Traditionally labs have chosen alloys with higher gold percentages for optimal esthetics, since alloys with higher concentrations of ...
Read more

Lemon Juice – The Good, the Bad, & the Sour

Image
In a great tale of opposites, lemon juice can be both acidic and basic, or alkaline. Read on to find out why people are talking about this, and what it means for your oral and overall health . What is pH and why does it matter? Drinking lemon juice (usually diluted in a glass of water or added to a cup of tea) is a beloved health tonic among fans of natural medicine. Potential benefits include lower cholesterol, lower inflammation in the body, and increased metabolism and energy. Lemon also contains high levels of antioxidants and vitamin C that boost your immune system. On a scale from 0-14, a pH of 7 is neutral (pure water) while numbers below 7 are acidic (unhealthy), and above 7 are basic or alkaline (healthy). Believers in holistic health blame many ailments on the body’s pH being too low or too acidic. Increasing your body’s pH is called “alkalizing.” Lemon juice in its natural state is acidic with a pH of about 2, but once metabolized it actually becomes alkaline with a pH ...
Read more