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Thanks for posting Richard, You can actually do it either way. However, the preferred way would be to:

1. access the screw channel and successfully remove the abutment.

2. Take an impression

3. Send the impression and abutment to the lab

Doing it this way would avoid extruding cement all around that implant.

It does take some care and some time…

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I wrote a short article on the topic not too long ago. Maybe it helps! https://implantninjadojo.com/how-to-access-an-implant-crown/

These positions look okay to me–but i might suggest some slight modification. So, because this is a partial, the implants don’t necessarily need to follow the angulation of the teeth.

Instead, the things to try to optimize for aside from bone availability are:

1. Parallelism between the fixtures. It would be great to try to get them…

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That said, you don’t want those anterior implants to come out too far on the palate because you’ll run out of restorative space. It’s a balance.

One solution for the anterior might be to use some angled locators on those. They fix that up real quick.

2mm subcrestal would be good. Hardest thing on this case will be making sure you have…

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The blue lines on a stacked implant guide are like the dimple on BioHorizons implants, they serve a similar purpose—they help ensure the implant is placed in the correct orientation, a process called “timing.” These markers act as guides to align the implant properly in the bone, ensuring that the connection where the crown or restoration… Read more

Hey Chris, thanks for your post! I would leave these UNsplinted. Here’s why:

There is already some bone loss at those implant sites and if you splint those, the situation can get worse as the patient wont be able to clean them as effectively. (What you said)

I can’t think of a benefit to splinting them in this case.

Also, you might have a…

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this one’s a doozy, not sure what I would do in this case !

This is really crazy. Thankfully I’ve never had to deal with that myself but in general you have to open up a window and get it out of these. When it’s that high up that’s a bit crazier

I would not shave down anything. If needed at time of uncover you can remove any bone around the cover screw as needed. That being said I always shoot for 2mm subcrestal to create enough running room for my crown. You want 4mm from top of tissue to implant platform. This is the cornerstone of ZBLC.