It’s funny how things come in cycles / clusters. Immediate implant provisionals seem to be my “thing,” lately.
I enjoy the challenge, and each case is a bit different. So, it seems I’m inventing new techniques as I go with each case.
Today’s case is a new patient. She moved down, mid-treatment, from “up north.” Her periodontist up north had placed an implant in site #9. Apparently, #10 had been grafted to prepare for a future implant. In the mean time, she has been wearing an Essix retainer as a temporary.
Her periodontist up north referred her to a periodontist here, who happened to be “my periodontist.” And, then my perio referred her to me. The plan was for my perio, Dr. Gornstein, to uncover implant #9 and place implant #10. Then I would place immediate provisional crowns on both.
I started with an exam and study models. I sent the study model for a wax-up of #’s 9 and 10.
Patient presentation pre-operatively. She also requested replacement of crown #11.
Instead of getting a wax-up back, I got what appears to be a printed model and a putty matrix (I didn’t request the matrix – usually make’em myself, but OK).
Not bad… but, #9 and 10 are longish. I can correct intra-orally.
Putty matrix from lab.
The appointments were set, and the patient would come directly to my office from the perio.
Implant #10 added by my local periodontist.
This is how the patient presented at my office immediately post-surgery. The periodontist provided the “PEEK” temporary abutments.
Occlusal view immediately post-surgery.
As I initially examined the surgical result, I didn’t think I’d need to reduce the temp (PEEK) abutments, but I wasn’t sure. The putty matrix is opaque, so with that, I could only “feel” if there was any interference. But, I wouldn’t be able to see if there was adequate clearance to avoid “show-through” of the abutments in the provisionals.
Then it occurred to me Continue reading Copyright protected by Digiprove © 2019 The Dental Warrior®