Le C APG #18

Three month post op of submerged #18 implant.

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Perio probe used through guide to poke a center hole.

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Surgical guide still fits.

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Unscrewing the cover screw through the gingiva did not work. The tissue was too thick. So a tissue punch was used through the guide.

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Tissue was incredibly tight. You can just barely make out the probe mark.

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Tissue punch. Lots of thick keratinized tissue to spare.

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Sweden Martin t-connect (tibase) inserted into abutment profile generator block.

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Clearfil Majesty ES-2 premium composite expressed into the model. (any composite will do)

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Composite is cured for 20 seconds in two layers.

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Cured composite.

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Here is the A3.5 composite, fresh out of the mold.

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The abutment and block were pressed against the screw to separate them.

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a bevel was added with the coarse polishing wheel.

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Diashine grey polish wheel was followed by Meisinger composite twist wheels. Polish as you would any other large composite.

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Mesial and distal relaxing incisions were placed. Assistant held down custom healer with backhanded spoon excavator. Abutment was tightened until pt was uncomfortable. After 5 minutes, the gingiva relaxed, and the custom healing abutment was fully tightened.

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Custom healing abutment placed. Pt instructed to return in 4 weeks (after holidays) for final crown impression.

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The healing abutment was actually in occlusion, despite being made as short as possible.

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Fixture level impression was taken in PVS.

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An improved tissue emergence was achieved with the custom healing abutment

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Sweden Martina's Premium implants have a very positive feel in your hand when they lock in place. The radiographic verification is extremely easy, too.

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Because of the extremely short clinical crown length, patient was informed that the metal would show from the top.

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Custom healing abutment.

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Gingival material was removed and the t-connect (not pictured) was attached to scan with the Cerec Omnicam. Sweden Martina is not officially supported, but a similarly sized tibase was substituted.

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e.max was milled on premise, fired, and cemented to the t-connect.

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Model poured with a little gingical material to make it look official.

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Final radiograph. Sweden Martina implants has a great radiographic and tactile fit to their prostheses.

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Buccal view of the restored #18 implant.

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Seated crown after composite plug and polishing. The titanium base shows because of the short crown length.

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Trained tissue makes the seating of the final crown much less traumatic for the patient.

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