March 22, 2010
Just learned that Straumann is going to be introducing a milled e.Max implant abutment in Europe later this month, and in North America sometime in June.
I don’t get it.
If its milled e.Max, then it has a flexural strength of 360 MPa. Most zirconia abutments on the market are in the 900-1300 MPa range. Somebody please explain why I would choose a material that is approximately 40-60% weaker than something that’s already on the market?
I’m trying to think of something –
Shade? Nope, we can make a zirconia hybrid abutment, featuring a titanium screw seat and interface, in all 16 Vita Classic Shades which I think would be sufficient for something that is, ostensibly, not seen. (BTW – in the images I saw, the e.Max abutment is solid e.Max – How well is that design going to hold up when you start torquing the screw?)
Fit? – Really? You’re telling me you can machine glass that has to be sintered to higher tolerances than titanium?
Cost? – I could see that if the company in question was Sirona. Maybe Ivoclar wants to use Straumann to prove the efficacy of the abutments, and then they’ll make a deal with Sirona so dentists will be able to mill abutments chairside while the patient waits?
If you have a possible explanation, please feel free to comment…
March 19, 2010
Had a client call yesterday regarding a patient of his that is an extreme gagger. The patient recently had a Biomet 3i Certain implant placed, and was reluctant to go through the impression process necessary to restore the implant. The client asked if there was anything available that would allow him to take a digital impression of an Encode healing abutment, rather than attempting to capture the impression in the conventional manner. I had been in contact with a certain manufacturer about a modeling process that was being tested for use with the Encode system, so I called to discuss my client’s predicament.
It seems there is research being done that will allow a Cadent iTero unit to digitally capture the position of the Encode healing abutment, and have that information downloaded into 3Shape’s CAD/CAM software where the abutment could be designed with the results sent to Biomet 3i for manufacturing. At the same time, a set of resin models could be manufactured with a facsimile of the milled abutment included. The laboratory would receive the abutment and the models, and fabricate the crown on the resin facsimile of the abutment. Once the restoration was complete, everything would go back to the dentist for final insertion of the abutment/crown complex.
I had to throw in my two cents and suggest that rather than have the printed model feature a replica of the abutment, it would be better to simply have the model contain a facsimile of the implant interface to which the actual abutment could be affixed. My way, if the milled abutment was deemed to need any alterations (Let’s face it – not everything you design on screen comes out exactly as you think it will), you wouldn’t be stuck with a useless model. You would simply adjust the actual abutment; connect it to the resin model and continue with the restoration as prescribed.
I was told that this process was in the clinical trial phase, and I am hopeful that my client’s patient may be asked to participate. Will update as needed…
March 12, 2010
Yesterday, we downloaded a new implant abutment library to our 3Shape scanner which will enable us to offer zirconia hybrid abutments at an exceptional value. We will be calling this new abutment – which is very similar to a Lava abutment – SDL Z-Brid Custom Implant Abutments.
Here’s the process –
You send in your implant level impression. We will fabricate an tissue model. The appropriate scan cap will be affixed to the implant analog in the model and we will take a series of scans – scan cap in place without the tissue element; the tissue element in place; and the opposing model.
Once all the data is in the software, we will select the Z Hybrid option which will automatically place an image of a titanium insert into the screen image. We then simply design – digitally – the coronal portion of the abutment which will fit over this titanium insert. That coronal portion will then be milled from zirconia on our Pro 5000 milling unit.
The zirconia portion can then be colored to the desired shade and sintered. The result is then cemented to the actual titanium insert using Relyx UniCem. You get the best of both worlds – a shaded zirconia abutment with a milled interface, and a the screw seat is in the titanium insert! No undue torque is placed on the zirconia!
We have a wide variety of interfaces available including Nobel Replace Select, Nobel Active, Bioment 3i Certain, Branemark, Straumann Bone Level, Zimmer and Neoss. For pricing information, please call me directly @ 800.678.7354
March 3, 2010
Had one of my clients call this weekend and ask for a favor. It seems a buddy was coming into town for two days, and needed a crown. He asked if it would be possible for him to impress last night; have the case couriered to my house; then have an e.Max CAD crown produced and back to him for cementation this afternoon.
Absolutely.
The case was dropped off about 8:30 last night. I brought it in with me this morning – he failed to mention it was an implant crown over a Straumann stock abutment on #14. We started the model work, complete with removable tissue, around 5:30am. I had the case in hand by 7:00am.
We scanned the abutment analog and the model using our 3Shape 700. The design was a little tricky as the implant was placed well to the palatal. After some finagling, we arrived at a design that provided good esthetics, and met the tissue without creating any type of ridge lap.
Once I was happy with the design, we milled the restoration using our B&D Origin Pro 5000. To be candid – I screwed up the milling a couple of times due to my unfamiliarity with the software (We’ve only done three of these to date!).
Once I fixed my CAM set-up flaws, I got a nice crown with great anatomy. I spent about five minutes adjusting the contacts and occlusion -most of that time was removing most of the “bounce” associated with the tissue facsimile.
A quick 30-minute speed crystallization, and a glaze firing (I dont’ have the guts to do the crystallization/shading/glazing in one firing), we had a damn nice result. The internal fit was great and the margins were completely closed.
The crown left the building around noon. Insertion is scheduled for this evening. Hope to post pics if I can get the client to share…
FYI – Received a message from the client that night. The crown was seated with a slight adjustment to the proximal contacts; “looked great”; and the patient caught his early evening flight with plenty of time to spare! Also, if you read the comments to this post you will note that the Pro 5000 is not a sanctioned milling machine for e.Max CAD. No one from Ivoclar has told me exactly what that means – you’ll have to draw your own conclusions. Just recognize that should request this “rush” service, you are doing so with the realization that the milling process is “unauthorized”.
