Dental Implant Impressions:

IMPROVING ABUTMENT FIT

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Disease and trauma are the leading causes of tooth loss. Millions of people are missing at least one tooth, which has led to significant growth in the dental implant industry.

One of the primary reasons for the popularity of implants as a treatment modality is their role in replacing missing teeth while preserving bone and acting as a placeholder to the adjacent dentition. This treatment has a significant effect on the patients' quality of life.

The implant industry has experienced incredible growth, and with this growth, many new abutment designs, material choices, and new processes have been developed to meet patient needs.

Implant Abutment Fit

One area that is of critical importance is the fit of the implant abutment to the implant platform. An ill-fitting abutment can lead to either biological failure caused by bacteria or mechanical failure such as implant fracture. Impression taking is one of the most important steps in ensuring a clinically acceptable fit is achieved. If an inaccurate impression is taken, this can lead to distortions. One way this is determined is when the abutment seats entirely on the model but does not fit the same in the mouth.

In addition to inaccurate impressions causing ill-fitting implants, other factors may play a role as well. For example, interferences may occur between the abutment and implant fixtures. Specifically, materials such as tissue, bone, and cement can become lodged at the implant interface and create problems with proper seating.

Other factors that contribute to ill-fitting implants are as follows:

  • Tight contacts can keep the abutment from fully seating and cause a gap.
  • The improper use of engaging and non-engaging abutments, especially in multi-unit implant cases where only non-engaging abutments should be used. 
  • Inadequately evaluating implant parts to ensure they are not damaged.
  • Inexperienced dental laboratories utilizing underperforming processes and materials. 

These are not the only factors that lead to problems with the fit of implant abutments, but they are the most common.  

Digital Scanning Success
Smart 1 Cr_Co Screw Retained F

Digital scanning methods provide a solution to ill-fitting implant abutments by improving impression taking which ultimately leads to better-fitting implants.

One of the great benefits of digital impressions is the ability to scan and then evaluate the scanned image on a screen. Any discrepancies can be addressed immediately and rescanned.

When scanning implant cases, it is essential to provide the laboratory with three scans: a tissue, scan body, and opposing scan (ideally) correlated to each other respectively, otherwise, a bite scan is also needed. Digital images can be shared between the clinician and laboratory to evaluate the data and discuss the design and material choice.

Standard or stock abutments, directly from the implant manufacturer, can be used when there are no issues with angulation. In these types of cases, a digital impression can be made with the abutment in place. In most cases, utilizing a custom abutment like the Smart1 implant (see image above) by Burbank Dental Lab is the best option. Custom abutments are specifically designed to address any issues with angulation, margins, and proper emergence profiles.

Digital Workflow Success Guides
Digital Implant Workflow
Digital Implant Workflow

One of the best ways to approach an implant case is to plan with the end result in mind. This method helps to ensure that the implants are correctly placed to achieve the desired outcome. The only limiter in the placement would be bone morphology. Guided surgery (see image above) helps to achieve precision in implant placement.

To begin this process, an intraoral scan is done along with a cone-beam computed tomography scan (CBCT). The STL file from the intraoral scan is merged with the DICOM file obtained from the CBCT scan, and this information is used to fabricate a surgical guide. This guide is then used to place the implants.

After the implants are placed, and osseointegration has been achieved, digital impressions are taken to begin the restorative process. To make a digital impression for an implant case, a scan body is used to relay the position, height, and angle of the implant digitally. The scan body selected plays a big part in ensuring a smooth workflow.

Scan Bodies
Scan Bodies - Burbank Dental Lab

Mostly, scan bodies (see above image) will follow two types of workflows.

First, when choosing scan bodies from major implant manufacturers, expect it to take more time and be at a higher price point.

The second option is to utilize scan bodies from 3rd party manufacturers.

At Burbank Dental Lab, we have had great success with cases using scan bodies from manufacturers such as NT-Trading and Medentika. Before making a decision it is good practice to call the lab and speak with the implant specialist and get a recommendation on which scan body to use with the implant being replaced. These companies fully support most major implant platforms.

By utilizing this workflow, the benefits include:

  • Value pricing
  • Reduced turnaround time
  • Precision parts

Once the scan body is selected, the digital impression process can begin. The following scans should be taken:

  • A scan of the tissue
  • A scan of the scan body
  • A scan of the antagonist

This data can then be transmitted to Burbank Dental Lab, where some of the most advanced CAD/CAM technologies are used to design a custom abutment (Smart1). These abutments are designed utilizing the parameters of the existing soft tissue and provide natural emergence profiles and contours. Once the abutment has been created, a crown can be fabricated to fit over the abutment. This can either be made as a screw-retained restoration or cement-retained.

Utilizing the proper impression technique is the first step. The design of the implant-abutment is critical in ensuring proper fit and function. Computer-aided design and computer-aided machining (CAD/CAM) has dramatically improved the ability to create custom abutments that provide excellent fit and promote healthy tissue. Specifically, Smart1  implants by Burbank Dental Lab utilize the most advanced CAD/CAM technology to ensure superior fit, contours, and emergence profiles.

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Fabrication
of the future
is here!

Burbank Dental Lab has three new state-of-the-art Carbon M2 printers. We are very excited about the options that these cutting-edge printers will allow us to offer our dental clients. Here are some of the advantages that these printers will begin to deliver to you and your dental practice.

Our New
State-Of-The-Art
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Carbon offers a highly dependable 3D manufacturing solution for many dental applications with its breakthrough Digital Light Synthesis™ technology, enabled by a wide range of dental materials.

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