Compromised prosthetic space?

Last Updated: Sep 22, 2017

I received this case to make the final crown. It’s a Straumann BLT 3.3 x 12 Narrow Crossfit. The fixture has some distal inclination. The x-ray lies a little bit. The healing cap isn’t that close to the adjacent teeth. I always prefer to make screw-retained crowns but maybe this case i won’t be able. What do you suggest? Is this too compromised?

10 Comments on Compromised prosthetic space?

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Drdave

09/22/2017

Custom abutment with cemented crown and you are fine

Craig Wright

09/22/2017

Ditto, Drdave! Watch your cement-don't use too much!

Craig Wright

09/22/2017

One more thing-3.3's are borderline imo for posterior teeth so watch occlusion as well!

Dr Robert Walton

09/22/2017

Assuming this is not as bad as it looks I would do some minimal reshaping of then mesial of the 2nd bicuspid to lower the height contour and create a contact area as opposed to a contact point. Take the impression and send it to the lab and ask for a screw retained crown. If that doesn't work then you're stuck with a cement able.

Dok

09/22/2017

Common problem. Easily restorable as mention above with custom abutment/cemented crown if off axis angulation is too severe. Also, good idea to reshape the mesial on 12 for better emergence and contact. Don't worry, be happy !! Dok

Implantdude

09/22/2017

Try to get impression post onto the implant, either closed tray or open tray, I would have both in case the closed tray would not fit, and like the others said lab should be able to make you a crown, in this case its most likely a custom abutment and cement retained crown. Let us know how it goes, good luck!

Gregori Kurtzman, DDS, MA

09/22/2017

You should be able to do a screw retained crown. Place the open tray head in the implant if need be modify the distal of the impression head so it can seat fully. Lab will then make the restoration. Remember you need less space on the distal for a screw retained crown then an abutment with cemented crown on top of it.

Richard Mondestin

09/22/2017

Simple ! you may distalise the 1st PM Orthodontically ( open contact point a bit betw. the 1st and 2nd PM if needs be) and do some mesial striping of the Bicuspid.

John

09/22/2017

The XRay looks worse than the actual situation. Judging by the xray, even the healing cap wouldn't fit. But it does. The screw driver doesn't touch the distal tooth.

Dr.Mario

10/10/2017

You may want to use the Variobase abutment from Straumann, it allows you to do a screw retained crown, or cemented. However the best is to have the cast with the implant analog mounted in the articulator. Straumann has a planning kit with plastic replicas of the abutments.

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