By: Pamela Hanneman
As dental technicians, we know that proper support for a dental restoration is one of the keys to success. When we receive flat preparations at the lab, we often call the Dr. to let them know the restoration will most likely fail without a build-up of the prep, or maybe even a post and core. On the other hand, when we get a normal size prep with an overabundance of occlusal space, it is expected to create a substructure with enough support for the porcelain application. So when it comes to a screw-retained crown or crown over implant why do we sometimes compromise? Is it a lack of parts in inventory at the time of need? Could it be that the vendor you use does not supply a Ti base of the needed height? Or maybe you just aren’t sure?
There is a direct relationship between surface space for cementing and the longevity of the mechanical bond. With every 1 mm of height, you can increase your bond strength by 25%. In return, the height reduces the chances of a failure coming back to the lab for the dreaded and costly remake. Most importantly, it increases the patient’s satisfaction by eliminating the risk of remakes due to debonding. The force generated during routine mastication of food such as carrots or meat is about 70 to 150 newtons (16 to 34 lbs). The maximum masticatory force in some people may reach up to 500 to 700 newtons (110 to 160 lbf). The more area we have for cementation and mechanical retention, the better! Making the customer happy with aesthetically pleasing restoration is our passion. It is our responsibility as dental lab professionals to provide 510K cleared medical devices. With Open Implants you can provide not only 510K cleared devices, but our products are proprietary and designed specifically with efficacy and patient safety first!
Let’s be honest, there are situations where we have to deliver a product in a time frame that is less than reasonable. The ability to have parts on-demand at all times without tying up too much of the finances in inventory can be challenging.
This is exactly why O.I. (real dental technicians) Freddy Rapp and Bob Cohen came up with the concept of having customizable Ti bases. The ability to have what you need on-demand and customize it for exactly what the case calls for helps the cost of inventory and helps get the case turned around faster with the best possible success rate for acceptability and longevity.
Does that mean I have to cut the Ti base? Yes, but it is simple and quick to do. Much faster than waiting on an order or even walking to the inventory room to get another part. Simply take a diamond disc and cut it to the desired length. Smooth with a polisher if desired.
How do I select the proper scan body and Ti base height in the 3Shape order form? Once again, super easy! The scan body doesn’t change based on Ti base height. The scan body represents implant position and platform. The OI library is preloaded with the corresponding height options because the people who created the Ti bases also understand how they are used in the laboratory and the workflows.
Aside from chimney height, we also need to consider cuff height in order to allow for a smooth and esthetic emergence profile. The proper cuff height not only improves esthetics but, if not chosen correctly, can cause Implant Mucositis: inflammation of the gums around the implant, much like gingivitis around natural teeth. I have heard technicians say the micro gap between the abutment and crown is not a huge concern because there is no risk of cavities developing. I agree that is a true statement, but gingival health is also a critical factor in implant success. We want to select the cuff height that will encourage healthy tissue regeneration and adaptation to a smooth biocompatible surface.
Think about the time spent designing custom abutments. There is much consideration for abutment height for proper support. When it comes to the emergence profile, even more care is put into the design to ensure a smooth cuff that follows the gingival height. You could increase production and profitability if you have a prefabricated Ti base with adjustable chimney height and cuff selection. Because you now have the option to customize a prefabricated base instead of the lengthy and more costly process of a milled custom abutment when it is suitable for the case in hand or the Dr’s request.
As a technician, production manager, and trainer, I have always focused on having a streamlined, predictable process using quality products. It is always appreciated when a product can provide quality and ease of use to complement lean manufacturing and inventory control. As the dental industry continues to change, the demands on the lab for faster turnaround and affordable restorations can be quite stressful. Open Implants provides you with the solutions your clients are demanding.