Parts for old discontinued implants needed: advice?
A 73 year old female patient I had seen for a couple of years had one molar replaced with two small diameter implants. The contour of the restoration was poor, but she did not have any signs of mucositis or pericoronaritis, until one of the periodic exams showed significant bone loss progression in a year. The periodontist recommended removing the crown and remaking it into two single crowns. So, to find out what implants were placed, I asked the patient about records. However it got really complicated, as patient had moved, dentists retired, sold practices, etc. I looked up the implants at whatimplantisthat.com and the best match I could come up with was a Camlog. I contacted the Camlog representative and he confirmed, sent me parts and I scheduled the patient to remove the crown.
Unfortunately, when I went in to remove the crown, I found solid abutments without a screw channel. Removal was tricky as I could not see any cement space, just drilling into what seemed homogeneous metal. Eventually the crown came off with a ton of resin cement on the under surface. Luckily the abutments fitted my Straumann solid abutment wrench. Even though one was really mangled, I was able to remove them, but this is where my luck dried up and it turned out they were not Camlog. The search for the identification of the implants continued on.
Many calls and hefty dose of luck later I got copies the original surgery records! The implants were O-company brand, now OCOBiomedical. I call OCO with the lot number, but I did not hear back from them for a few days. I called again and it seems they did not have any of the parts for these implants, as they have been discontinued long time ago.
So I am looking for any restorative parts – impression copings or abutments that will fit these implants, a lab that can machine them or any other advice. Any ideas here?
23 Comments on Parts for old discontinued implants needed: advice?
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Peter Hunt
3/8/2019
You have done a wonderful job in tracking down the technology being used here. But it's also necessary to assess the biology of the local environment. There is quite extensive bone loss in between the two implants. It would be difficult to improve the situation very much by converting this to two units.
Perhaps it would be better to think of removing the two implants, then immediately placing a new larger diameter implant, There would need to be bone augmentation where the former implants resided, and a concurrent sinus lift. It would be complex and time consuming, but would have a good prognosis as for her age the patient seems to have excellent bone support elsewhere.
Good luck!
Richard Hughes
3/8/2019
I agree with Dr Hunt except for the concurrent sinus lift. I would bone graft and revisit at a later date and place the implant and uplift via Densah burs or osteotomes.
Carlos Boudet, DDS DICOI
3/8/2019
If you are trying to salvage the implants and there are no parts available you can do the following:
Treat the periimplant problem back to health first and then,
If the abutments are solid with no indexing feature you have to place them back on nthe implants, torque them to specs, prepare them and take an impression.
Your lab then needs to fabricate a new crown for you.
Be aware that this is not ideal treatment, but one that your 73 year old patient might be very grateful to receive.
Dr. Gerald Rudick
3/8/2019
What does the patient want? Is the patient willing to go through a surgery to remove the implants?...a second surgery to graft the bone...and a third surgery to place a wider diameter implant?...….this seems like a lot of surgery for a patient who is not even aware of the bone loss, as it is not bothering her.
A much simpler solution , it seems to me, from the limited view of the xrays, is that the distal molar seems to be a solid tooth that could be used as an abutment with the adjacent bicuspid and make a three unit bridge ……...cover screws could be used to close the implant holes, some bone grafting could be used to fill the damage around and between the implants; a temporary bridge could be used for several months to observe the health of the tissues.... and see what happens....not major surgeries, less traumatic for the patient.
Sean Rayment
3/8/2019
Great suggestion! I was getting sucked into the implant tunnel vision mode and never even considered conventional fixed bridge.
Dr. Gerald Rudick
3/8/2019
An addition to my comment above....if it is not possible to locate cover screws that will fit......bone wax, composite or GIC could be used to close and block the holes in the implants ….any of them would work.
Montana
3/8/2019
Good chance they’re Integral by Calcitek; a company long departed. I believe Implant Direct bought the rights and so may have components. I wouldn’t bother with bone grafting around the implants if they are Integral, as the surface is HA coated and you have zero chance at disinfecting it. Most press fit implants from the late 80’s to early 90’s suffered significant bone loss as time passed and the failure rate was high in general. Hence, they vanished from the scene.
Ivan Paskalev DMD
3/12/2019
They are not Calcitek, I checked. And Calcitek is now Zimmer.
Montana
3/8/2019
Additionally, there’s no anti-rotation feature to the implant thus the need to splint.
Dr Dale Gerke, BDS, BScDe
3/8/2019
All the above replies are appropriate and should be carefully reviewed.
However if you want to use the existing implants then you could use the existing abutments as impression copings (ie as if it was a closed tray technic). You might need to “slot” the abutments so you can locate them properly in the rubber impression (after removal).
However it appears the implants are non-engaging so you need to be sure there will not be any rotation of the crowns once fitted. Given your difficulty in removing the abutments, it seems that rotation might not be an issue but you need to consider the possibility and cater for it.
If you cannot reuse the existing abutments (ie if the lab cannot construct crowns on them) then you should be able to find an engineering manufacturer who can copy them (you can design whatever core shape you wish). Alternatively, Nobel or Astra have associate milling facilities and they might be willing to help in this regard. If you are unable to progress then contact me and I will aim to help. I have access to a local engineer who successfully mills copy parts to your requirements (ie he helps dentists who are faced with the exact problem you have now).
If you need temporary healing “caps” or abutments while you are having lab work constructed then I have found that you can squeeze light body rubber impression material into the internal channel of the implant and over the platform and let it set and it will provide a temporary solution for 3-6 weeks. You can flick it out once the lab work is back and ready to be inserted.
Ivan Paskalev DMD
3/12/2019
Thanks for the suggestions . Even if I was to use the abutments as impression copings, I do not have implant replicas.
I may just need to try a conventional C&B impression. I was really hoping I could avoid cementing the prosthesis, but it looks like I may not have other options.
I am still waiting on OCO to see if they can machine something for me.
Incisor
3/8/2019
I suggest you consider the implants as two divergent roots. Take an impression or scan and send the file. Your lab can make you an abutment with removable post (if insertion dictates the need) mill it and send you the crown + milled abutment post core with insert pin. If you need any prosthetics I would be glad to help.
Matthew, DMD
3/8/2019
Surprised OCO can’t machine you a coupe of those. I use them frequently and they machine all their stuff. May try them again and see if they would consider it. The other option may be PREAT. Download their app. They tend to have a large volume of implant parts that are discontinued.
Good luck
Ivan Paskalev DMD
3/12/2019
Thanks for the suggestions . .
I am still waiting on OCO to see if they can machine something for me.
Will contact PREAT.
Peter Sabolch, DMD
3/8/2019
Simply prep two crowns, as it is, where all contours are are biologically acceptable, and have the periodontist treat the affected areas as needed.
Joe Orrico DDS
3/8/2019
These look like Duodent implants. Pre internal hex. Flat top . 3-3.5 diameter. Call me next week, still have parts. Think we can help .
Brandon Wood DMD
3/2/2020
Hello Doctor Orrico. I'm not sure if you check these message boards... Do you happen to know what drivers will engage the screws in duodent implants? I have a loose abutment and I don't know what I can use to re-torque it
Ed Dergosits
3/9/2019
Cleanse the interior of the implants and place the solid abutments back on. Make a concentional crown impression and have a new splinted restoration fabricated with open access to the "furcation" with a softpik or proxibrush. Insist the patient get a waterpik and make certain she knows how to use it daily. The restoration will service for the rest of her life. Keep it simple.
Ivan Paskalev DMD
3/12/2019
It looks like that is what I will end up doing. I was hoping I could avoid cement or at least bring the margins of the prosthesis supragingival, but I may not be able to.
Dr Dale Gerke, BDS, BScDe
3/13/2019
If you are going to go down this path, perhaps consider using the old crown but either you or the lab modifying the impression surface to reduce food trapping undercuts and to open the area between the two implants. It will take a bit of effort but it will be cheaper and easier than making a new crown and trying to find impression copings and analogues. Of course this is presuming the crown is in reasonable condition (you might have destroyed it during removal?).
Ed Dergosits
3/9/2019
There are mountains and there are mole hills. If this was my patient I would recommend a new splinted restoration connected to the existing implants and abutments that has intelligent design that enables the patient to cleanse between the implants with a softpik or a proxibrush. The initial restoration was very poorly designed and disabled the patient to cleanse between the two implants. . If a restoration is placed with easy access for cleansing with a proxibrush the patient will continue to have "teeth" to chew with and will not need extensive treatment. Why make this case more complicated than it needs to be?
Sam
3/12/2019
Now that you have the solid abutment out you can ask your dental technician to make the core of the crown on it then place the abutment and core on the implant then take the impression.
AAM
3/23/2021
Looking for a restorative screw and an angled 15 or 25 degree abutment OR UCL attachment for a TG 3i implant placed in site #10 over 20 years ago by another office with no history. Seems the implant and parts have been phased out.
