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Clinical Tip: Go online for in-depth content Implant Orientation for Inclusive® Tooth Replacement Solution Components by Bradley C. Bockhorst, DMD and Darrin M. Wiederhold, DMD, MS The Inclusive ® Tooth Replacement Solution from <strong>Glidewell</strong> Laboratories features custom temporary components designed to guide soft tissue contours during the healing phase. Whether you utilize the custom temporary abutment or custom healing abutment, the following guidelines can help to ensure a smooth delivery at the time of surgery. Aligning the Abutment Connection The custom temporary components of the Inclusive Tooth Replacement Solution are designed, presurgically, with one flat of the internal hex positioned toward the facial. During surgery, the final position of the implant should match this orientation. This is accomplished by aligning one of the flats on the implant driver to the facial (Figs. 1–3). If the seated abutment is rotated slightly, it can be removed and minor adjustments made to the rotational position of the implant. Seating the Custom Abutment Assuming there is adequate attached gingiva and no grafting is planned, flapless surgery can minimize postoperative discomfort and swelling, leading to higher patient satisfaction. Also, because the periosteum is not reflected, the blood supply to the bone is not disrupted, reducing potential resorption. With the growing popularity of minimally invasive surgery, the use of a tissue punch (or other tools, such as a laser) can make it much simpler to seat anatomically contoured abutments during a flapless procedure (Figs. 4–9). Once adequate tissue has been removed, the custom temporary abutment is seated and the abutment screw tightened to 15 Ncm. A periapical film should be taken, if necessary, to verify complete seating. The screw opening is sealed and the BioTemps ® provisional crown (<strong>Glidewell</strong> Laboratories) is seated with provisional cement. It is absolutely critical that all excess cement be removed and the temporary taken out of occlusion. In flapped cases, the abutment can be delivered and the complete seating visualized directly. The soft tissue can then be reapproximated and sutured around the abutment (Figs. 10–12). IM Figure 1: Flat to facial in flapped case Figure 2: Flat to facial in flapless case Figure 3: Final implant position 14 – www.inclusivemagazine.com –
Case 1: Tissue Punch Figure 4: Tissue punch Figure 5: Custom temporary abutment seated Figure 6: BioTemps crown cemented into place Case 2: Laser (Case courtesy of Dr. Dean Saiki, Oceanside, Calif.) Figure 7: Laser-assisted gingivoplasty Figure 8: Custom temporary abutment seated Figure 9: BioTemps crown cemented into place Case 3: Flapped Figure 10: Custom temporary abutment seated Figure 11: Flap sutured around abutment Figure 12: BioTemps crown cemented into place – Clinical Tip: Implant Orientation for Inclusive Tooth Replacement Solution Components – 15
Page 1 and 2: Inclusive Restorative Driven Implan
Page 3: Contents ALSO IN THIS ISSUE 14 Clin
Page 6 and 7: Publisher Jim Glidewell, CDT Editor
Page 8 and 9: Clinical Benefits of the Inclusive
Page 10 and 11: Inclusive Tooth Replacement Solutio
Page 12 and 13: Healing Phase As with any implant t
Page 14: Figure 21: BruxZir crown cemented i
Page 20 and 21: Digital Manufacturing Process The p
Page 22 and 23: •Step 3: Milling of Custom Compon
Page 24 and 25: Building a Referral Network Through
Page 26: Figure 4: A custom impression copin
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Page 31 and 32: DW: Right. The thing that you gain
Page 33: BB: A colleague of mine refers to G
Page 37 and 38: Among the newest breakthroughs is t
Page 39 and 40: as all patient-specific temporary c
Page 42 and 43: Clinical Tip: Placing Custom Healin
Page 45 and 46: Restorative Driven Implant Solution
Page 47 and 48: the laboratory in the creation of a
Page 49 and 50: a b Figures 11a, 11b: Digital radio
Page 51 and 52: Figure 5: A surgical guide was then
Page 53 and 54: Figure 17: Due to the lower-than-re
Page 55 and 56: teeth, placement of a 3.7 mm diamet
Page 57 and 58: Congratulations, Inclusive Image C

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