Components for the closed tray reposition technique include:
This is a simple and intuitive procedure with the plus system. After second stage uncovery and adequate healing, the gingivaformer is removed and the standard impression post cum straight abutment is placed into the implant. The abutment screw is fastened and the plastic transfer cap indexed to the flat of the impression post.
A high viscosity monophase silicone or polyether material is syringed around the impression post and the tray loaded with the same material placed over the impression post.
After the impression has set the tray is removed with the transfer cap that is locked into the impression material.
The impression post is removed from the mouth and the gingivaformer placed back into the implant. The impression post is now placed onto the laboratory analog and the abutment screw tightened to fasten the assembly. The assembly is now repositioned and oriented to the flat face in the impression and is securely repositioned into the transfer cap within the impression.
Soft tissue make material is expressed and applied to cover the implant abutment interface. After that die stone is poured to produce the final working model.
Modification and laboratory procedures for standard titanium straight and angled abutments are common
Standard abutments can be held in a laboratory analog or special abutment holder for modification with rotary instruments.
The final anatomically modified abutment in place on the working model.
Using a conventional wax-up and casting technique a precious metal base coping is prepared.
The ceramic crown is finished using standard ceramic layering techniques.
An occlusal view of the finished single crown.
The standard PLUS angulated abutment can correct angulation from placement upto 15 degress.
For angulation beyond 15 degress the Resolve cast to base abutment is the abutment of choice to customise an angled abutment.
The Resolve abutment must be individualized using a diamond disc or other suitable cutting tool. Wax can further be added to modify the abutment to any angulation the laboratory feels the need to correct upto.
The finished abutment should reflect the ideal stump leaving enough space for the ceramic crown.
A sprue spring can be attached using the conventional principles for casting. Cast-on techniques should be accomplished using a precious metal alloy only.
During the de-investing procedure the implant abutment interface should be protected with wax to ensure no blast media touches the interface area.
The final customised abutment now in place can be treated like a standard abutment for further crown and bridge procedures for either cast or milled copings and crown & bridge procedures
In this case a wax up for an E Max press crown is prepared.
Palatal view of the wax up for a lithium-disilicate coping.
The finished E Max pressed coping in place on the abutment.
The finished E Max pressed coping in place on the abutment that’s ready for ceramic layering.
E Max press crown layered with E Max ceram
With this kind of cast – to base solution it is important the implant abutment interface connection area should be clean and undamaged.
The finished crown in place.
The abutment in place prior to modification.
The Zirconia abutment must be individualized using diamond tools and water cooling.
Scanning the abutment for the milling centre.
The finished Zirconia milled coping in place on the modified abutment.
Labial and incisal layering of the final crown using E max ceram.
Layered crown after the first firing of the ceramic.
Second layering of the aesthetic shade of the ceramic
The crown after the final firing.
The final finished crown in place.
After crown trial the gingivaformer is removed for the final time and the final abutment indexed into the implant. The abutment screw is recommended to be torqued optimally to 30 Ncm.
The abutment aperture is protected with a material like gutta purcha, or a temporary filling material to ensure that the screw aperture is protected from the luting cement. The final crown is lined with cement and the crown cemented into place.