Bicon Dental Implants
Friday, November 21st 2008 6:56PM EDT

All-Ceramic Crown: Less Than Ideal Abutment Position
This case demonstrates the impression, temporization and insertion of an all-ceramic crown on a shouldered abutment with a less than ideal submucosal shoulder height.
     


1. Radiograph of a 4.5mm x 11.0mm implant with temporary abutment taken immediately after implant placement.


2. Labial view of 5.0mm x 2.0mm x 3.0mm shouldered abutment. A 5.0mm x 4.0mmx 3.0mm abutment would have positioned the shoulder more ideally.


3. A 5.0mm short one-piece acrylic sleeve being inserted onto shouldered abutment for the making of a transfer impression.


4. Seated one-piece sleeve. The flat side of the one-piece sleeve corresponds with the anti-rotational flats on the abutment.


5. Impression material being injected around the one-piece sleeve.


6. White transfer die being inserted into the one-piece acrylic sleeve which was picked up in the full arch transfer impression.


7. Transfer die seated in the one-piece acrylic sleeve prior to the pouring of a soft-tissue stone model.


8. Occlusal view of abutment prior to the fabrication of a transitional crown.


9. One-piece acrylic sleeve being inserted for the fabrication of a transitional crown.


10. Composite resin being injected around one-piece sleeve, for fabrication of transitional crown.


11. Transitional crown being inserted. Cervical portion is the one-piece sleeve.


12. Transitional crown snapped onto abutment without any cement.


13. Transfer die in stone model with the soft tissue material removed since the shoulder margin is 4.0mm submucosal.


14. Aluminum oxide sleeve on transfer die prior to having porcelain added.


15. Aluminum oxide sleeve being adjusted, as it is held on an abutment in an abutment prep holder.


16. All-ceramic crown on stone model.


17. Mirror view of all-ceramic crown.


18. Perio probe indicating a sub-mucosal shoulder depth of 4.0mm. A more appropriate abutment to have used would have been the 5.0mm x 4.0mm x 3.0mm which would have raised the abutment shoulder by 2.0mm.


19. Metallic coupler being applied to abutment.


20. Ceramic coupler being applied to internal aspect of aluminum oxide sleeve.


21. Bonding agent being applied to abutment.


22. Bonding agent being light cured.


23. Vaseline being applied to facilitate removal of extraneous cement.


24. Minimal polyceramic cement being applied.


25. All-ceramic crown cemented onto shouldered abutment.


26. Radiograph of cemented all-ceramic crown.
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