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Implant Prosthetic Planning
Good day to all, I am having some issues with this case which was performed without a surgical guide. The fixtures were placed too distally and lingually tilted. I would like to get your expert opinion on the design of the final crowns.
1) Would it be better to join the crowns together to dissipate the occlusal force ? since the screw access channel is not at the center of the crown, located more towards the distal of the crown
2) How much can the final prosthesis compress on the gingiva? (is 1-2mm acceptable?) The diameter of the healing abutment that I used was 6.5mm but seemed like the emergence profile is not sufficient to accomodate the final crowns.
Thank you and have a nice day !
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1 Reply
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Hello William,
The design looks relatively good relative to how the implants were replaced. As you drew the lines, you could obviously make a better emergency profile from the head so there’s more of a convex rather than concave emergence profile. You could get a little tissue compression may be around a millimeter or so, but it just depends on the bone levels around those implants. Depending on the type of implant that was placed yes you could have some screw loosening if the patient has a strong bite that typically is less of an issue with newer implants and OEM parts, but can still happen so splitting them together would absolutely minimize that but then you have more of a hygienic issue potentially. There’s not just one way to correctly restore them but if the patient is a grinder and has a heavy occlusal load, you can spin them. If not, you can keep them separate and just have the lab make the profile transition smoothly from the head of the implant to the light tissue compression and you should be good. I have seen many restored like that that have worked out very well with no issues
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