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Ideal emergence profiles for implant-supported restorations

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Dentists who combine analog impression and digital scanning techniques with computer-aided design and computer-aided manufacturing technology can develop a prosthetically driven emergence profile for implant-supported restorations. The 6-step technique is detailed in an article published online in The Journal of Prosthetic Dentistry.

Advantages of the 6-Step Technique

  1. The length of healing abutments can be ignored.
  2. Sculpting soft tissue is no longer necessary after using the custom healing abutment.
  3. Custom anatomic abutments can overcome the limitations of stock abutments, which cannot approximate all contours during healing.
  4. The procedure takes less chair time, and computer-aided design and computer-aided manufacturing technology allows dentists to make a custom abutment or screw-retained implant crown with a definitive emergence profile.
  5. The technique eliminates laboratory costs and eliminates laboratory errors when the gingival mask can be designed while fabricating the definitive restoration.
  6. Reducing repeated disconnection of components from the implant also minimizes the loss of peri-implant bone and soft tissue.

Examine and radiograph the implant and obtain a conventional impression and digital scan with an open tray impression coping and scan body. Dentists then pour a stone die and replicate the soft tissue with a gingival polyvinyl siloxane material and use a surgical blade to sculpt it into a definitive emergence profile.

Use a Ti- (titanium) insert and block out resin to obtain a custom healing abutment from the modified model. The abutment would be placed after administrating local anesthetic.

Make a new scan that captures changes made to the silicone material and add it to the initial scan as a gingiva mask in the Chairside Economical Restoration of Esthetic Ceramics (CEREC) software.

Reduce soft-tissue margins in the gingiva mask folder to achieve an emergence profile to match the custom healing abutment.

Design and mill a screw-retained monolithic crown from a lithium disilicate block. Ceramic material is crystallized and glazed. Dentists then bond the monolithic crown to the Ti-insert with a chemically polymerized opaque resin cement.

After the healing period, the final step requires dentists to remove the custom healing abutment and deliver the screw-retained restoration with optimal soft-tissue support.

Original Article

Julian Conejo, Pablo J. Atria, Ronaldo Hirata, Markus B. Blatz. Copy milling to duplicate the emergence profile for implant-supported restorations,.The Journal of Prosthetic Dentistry, 2019 [Article in Press]

I hope you you find the  presentation informative. We always look forward to hearing your thoughts and receiving your questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
Chiraz Guessaier, CDA Oasis Manager

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