Thoughts on taking final impression for a crown on implant?

I have found many times that the crowns I get back from the lab when I use impression copings and open or closed tray impressions require considerable adjustment of the occlusal and interproximals.  Recently, I’ve been torquing the final abutment down to 30-35 Ncm and just taking the final impression on that. Then I leave the abutment on (covered with some integrity temp material so it doesn’t bother the tongue). This way I don’t have to bother with the impression abutment, implant analog, etc. The crowns come back with much better positioning and less adjustments/ redos necessary. Anyone else doing it like this??

2 thoughts on: Thoughts on taking final impression for a crown on implant?

  1. ljo, DMD says:

    Do the crowns properly fit the model? If so the impression may be the problem. Both the labs I use consider triple trays inappropriate for implant restorations. I use full trays and high quality impression material. No problems with fit. You can use a bite reg including a healing cap on the implant and include that cap in the lab items. Might try a different lab. Too tight contacts can be created by damaging the model’s proximal surfaces.

  2. Duke says:

    1. I assume that you are using the same lab for your regular C&B and not having the same problem.
    2. What you are doing is okay, a decent work-around, but the fit may not be as good on the abutment as if the crown was made on the actual abutment, i.e. possible future cement wash-out problems.
    3. I agree with Ljo, how is the fit on the model? Personally, I’ve been doing mplants for 30+ years and I still set the analog into the impression, paint die stone on the analog to lock it into the impression (sometimes need to use Tru-Soft as tissue subsititute), and after the die stone has hardened pour up the rest of the model. I know, very old school, but I very, very rarely have a problem with what I get back from the lab.

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Posted in Clinical Questions, Restorative.
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