Workflow visualization for Atlantis titanium custom abutment, Astra EV #31 guided 4.8 mm X 9 mm.
Pre-op implant case plan in Galileos XG3D CBCT for Astra EV in the #31 position. THe tooth had exhibited typical endodontic failure with crack through furcation with 9 mm buccal pocket. Tooth was sectioned and extracted in multiple pieces preserving the site.
Post-op Informational CBCT was exposed for verification of exactness of guided placement.
Healing cap present. Boring.
Implant table visualized. CEREC scan was accomplished with scan post and scan body. File was sent via Sirona Connect to Atlantis.
Core file was returned and downloaded to CEREC but the abutment design required two iterations before the occlusal space management was acceptable. The Zirconia crown was milled and fired before the patient arrived and the case was delivered in less than ten minutes after removal of the healing cap with no adjustments.
Abutment torqued into position to 25 nt-cm as per Astra spec., plumbers tape placed into abutment and closed with Fermit.
Basic zirconia crown delivered with Fujicem RMGI. If you haven't watched Skramy's 7 videos for this worklow I would highly recommend that you take the time to view them. I made the mistake of checking them out AFTER (dope) beating through the case but it was still a good learning experience. The workflow is very doable given that we no EV parts and pieces yet.
Bitewing exposed to visualize the great fit of the abutment to implant table.
Crown cemented with superb marginal adaptation.
Great case and documentation! Just kind of takes all of the stress out of implant dentistry with this kind of workflow.
Karl,
Very nicely done. You made it look easy but a guided surgery in site #18 is never easy. Also: The Atlantis workflow with the titanium abutment may be biologically better in certain situations as compared to the EV tibase solution (once available here in the U.S.).
Farhad
