CLINICAL TIP: To ensure accuracy in the fabrication of the Analog Placement Index, the luting material should not engage or overlap the impression coping/analog interface.
Eight weeks following implant placement and uneventful healing, a periapical radiograph was taken. The radiographic appearance of the crestal bone height at the Certain® PREVAIL® Implant/Encode® Healing Abutment interface was observed at the same level as the day of implant placement (Figure 6). It was also observed that the radiographic appearance of the traditional external hex Implant-Abutment Junction (IAJ) of the implant replacing the mandibular 2nd premolar was at the level of the first thread. With the design of the Certain PREVAIL Implant, the location of the Implant-Abutment Junction (IAJ) is moved to a more medial position (see Discussion).
The clinician confirmed that following soft tissue maturation, all of the codes of the occlusal surface of the Encode Healing Abutment were visible above the level of the soft tissue (at least 1mm) for recording in the impression. An elastomeric impression was made of the Encode Healing Abutment (Figure 7). The impression and the selected shade for the porcelain fused-tometal crown were sent to the commercial dental laboratory.
CLINICAL TIP: In order for the scanner to accurately record the data from the occlusal surface of the Encode Healing Abutment, the scanner needs to be able to “see” all of the codes (3- dimensional markings). If the soft tissue interferes with access to the full circumference of the abutment, the Encode Healing Abutment should be replaced with a taller abutment.
The impression of the Encode Healing Abutment was poured in yellow Type IV die stone i.e., GC FujiRock® EP (GC America, Alsip, IL) (Figure 8). The casts were pinned and sectioned per conventional fixed prosthodontics and mounted in the center of the recommended articulator, Stratos 100®, 3i Package (Ivoclar Vivadent Inc., Amherst NY). The work order for the Final Encode Abutment was completed by the dental laboratory technician and the articulated casts were sent to 3i for scanning, computer design and milling of a CAD/CAM abutment for fabrication of a patient specific restoration.
Figure 9
Figure 10 Figure 11
Figure 12
