Simplifying Implant Dentistry - JDT Unbound

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of the abutment. It is not likely thescrew of the healing abutment willcome loose but if it does this will causethe healing abutment to rise due to thehydraulic pressure introduced whenthe impression is taken. It is crucialthat there are no bubbles, rips, tearsor imperfections in this impressionaround the implant site. The reasonfor this is the scanner, which is used inthis CAD/CAM technology, may readthese imperfections as something else.The requirement for this impression isthat the healing abutment be at least1mm supra-gingival (Figure 6). Animpression coping is not indicatedin the production of a final Encode ®Abutment. Simply take a clean, clear,full arch impression of the healingabutment, followed by a full archimpression of the opposing arch and abite registration.The dental technician willpour up the impression with a lowexpansion die stone, free of bubbles(Figure 7). Articulate the models onan articulator within the confines ofthe mounting plates (Figures 8). Onlyarticulators compatible with AddessoSplit Plates, such as the Stratos 100articulator, can be used to replicatearticulation at the milling center. Forthis reason, articulators do not need tobe shipped, only the working models.Filling out the prescription is avital step in the Encode ® Completeproduction process and knowing yourdentist will help you with this process.Your dentist should answer severalquestions as completely as possible.How far sub-gingival should marginsbe buccal, interproximals, and lingual?Is a chamfer or shoulder marginpreferred? What should the abutmentwalls be parallel to and to what degreeof taper? Do you want to stretch any ofthe emergence profiles? Is the implantutilizing a platform switch design?These questions are filled out on theFigure 3 Figure 4Figure 5Figure 6Figure 7August/September 2009 Journal of Dental Technology 31
Figure 8Figure 9Encode ® Complete work order form andshipped out to 3i’s PSR department inWest Palm Beach, Fla.At the PSR department at 3i, adental technician reads the prescription,scans the models and the abutment isdesigned virtually. Upon request, thedigital photos or electronic drawings ofthe abutment are sent to your e-mailaddress to be reviewed and revised ifneed be (Figure 9). After approval ofthe digital photos, the milling machinecan get to work (Figure 10). First, theabutment is milled out of a block oftitanium (Figure 11) with a preciseBiomet 3i interface. Then, the workingmodel is revised to fit an analog in it’sproper orientation. At the same time,the milling is done on the workingmodel to create the proper socket shapefor the emergence profile portion of theabutment to fit in (Figure 12), whichthe computer knows by the scanningof the opposing arch and the adjacentFigure 10dentition to the implant as well as thecross arch dentition.After completion of the robotmodel and the abutment, they aremailed back to the dental laboratory.A porcelain fused to high noble crownwas fabricated over the Encode ®Abutment and polished (Figures 13and 14) by the laboratory.The doctor removes the healingabutment, seats the implant abutment(Figure 15) and takes a radiograph toverify proper interface seating. Aftertorquing the abutment screw to 20Ncm (CERTAIN) or 32 Ncm (EX-HEX) the crown is cemented (Figure16).Needless to say this soundseasy — and it really is. Eliminatingthe need for an impression coping tofabricate the restoration of an implantwill change implant dentistry. Also,it will save chairtime and cost. It willreduce the amount of componentsneeded to restore implants, makingthe process less confusing, at the sametime providing the patient with a highquality,patient-specific restoration.In the last year at my laboratory,we have fabricated more than 300Encode ® Abutments and crowns withexcellent results. Biomet 3i Encode ®Complete Restorative System offers tothe dentist a simple, less confusing wayFigure 1132 Journal of Dental Technology August/September 2009
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