What abutment do I need to restore this case?

Patient had these implants placed at another office 3 years ago. Does not remember the brand. I think they are Nobel Replace? They look slightly mesially angulated. If I am to restore this case, what type of abutments should I use? 17 or 30 degree? Does any one know the specific name or pat number of the abutments that I should purchase from Nobel Biocare? I do not use Nobel and therefore am not familiar with their system. Any other thoughts on this case?


![]WHAT ABUTMENT TO USE?](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2015/01/whatabutmenttouse.jpg)WHAT ABUTMENT TO USE?

12 Comments on What abutment do I need to restore this case?

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NIS
1/13/2015
to measure d exact angle for abutment ..u need to have models of ds case in articulation. most probably u will be needing ucla abtments non hex to fabricate cast abutments. Good luc
Germán Valenzuela Peña
1/13/2015
other choice is make a personal abutment machined for this case in special, they can do the right angle and you do a best crows work.
rwalton
1/13/2015
Definitely ucla abutments. The real question is which impression coping do you need. If you remove the healing abutments and these are Nobel implants you will see a tri-lobe attachment not a hex. Three years ago that was Nobel's only attachment. I can't tell the diameter from the radiograph but the impression copings come in 3.5 4.3 and 5.0mm diameters. Hope that helps.
mwjohnson dds, ms
1/13/2015
make an impression at the implant level and make custom abutments like the Atlantis system. That way the angles really don't matter; the custom abutments can be made parallel to the path of insertion then cement the crowns.
Peter Hunt
1/13/2015
From this single radiograph, it would appear that the implants are not only mesially angled, but half out of bone and probably only 3-4mms away from the occlusion. Do you really want to compound the problem and get sucked into the vortex. Would it not be easier to remove the implants and to start over? It would appear easy enough to remove these implants and to immediately insert new ones at the correct angle, in bone and with good inter-occlusal space
Alex
1/13/2015
This case is a good example how guided surgery would have avoided this prosthetic difficulty in the first place.
CRS
1/14/2015
Whoa hold on here this is a panorex which can be misleading. May want to consider crowning the molar for more room How does it look clinically? Looks to me that they chose to line up with the molar vs the premolar. This is tough since you don't know the original prosthetic plan, I would call the other office and get the info. No shame here the patient came to you but you may have inherited a problem just get good informed consent. The prosthetic advice posted above is as always excellent.u
Tony Collins
1/14/2015
You say they were placed at another office. Have you called them? The pt may not 'remember' the brand, but the office SHOULD have a complete record. Need a periapical film to check crestal bone level. Remove one of the healing abutments and check with the local NB or other company reps for identification. Would suggest forgetting about seeking angled abutments and go for screw-retained splinted crowns - there is a clear unobstructed path for the screw access holes (and they are even conveniently angled mesially). Tony Collins AM
mpedds
1/14/2015
There should be no problem restoring these. Implant Direct has what is called a laboratory abutment. They are titanium and cost $80. They fit perfectly. Have your lab mill them to any angle of draw you need. Nothing special here, no need for angle abutments.
mak
1/14/2015
Screw retained linked-crown, UCLA.
Mike Heads
1/21/2015
I have used Nobel Replace implants both tri-lobe and conical connection for years and I am certain these are not Nobel Replace implants
CRS
1/30/2015
I believe there is an implant company in Pisa Italy who makes an abutment with the appropriate "lean". Sorry.

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