NotesE a s t e r n O k l a h o m a P e r i o d o n t i c s

Summer 2017

Kelly Profess ional Bui ld ing • 6565 South Yale Ave. , Ste. 1008 • Tulsa , Ok lahoma 74136 • 918.492.0737 • w w w.eoper iodont ics.com

Summer!

www.eoperiodontics.com

Eastern Oklahoma Periodontics

Does it get any better? We are having a great summer in here at Eastern Oklahoma Periodontics. For this summer’s quarterly newsletter, I am covering a topic I have addressed before, but I am still getting questions, so here it goes. Why use custom abutments over stock abutments?

First, you have total control over where the cement margins are. With a stock abutment, you may have multiple heights to choose from, but with a custom abutment you have total control. With margins in the proper posi-tion you will be much less more likely to have subgingival cement if you are doing a cemented restoration.

Second, the emergence profile. Most stock abutments are round. There is pretty much not a single tooth in your head that is round. They are oval shaped. Why they don’t make stock abutments more in the shape of teeth I do not know. Custom abutments can be deigned to have a very realistic and natural emergence profile. A more natural emergence profile translates to better esthetics, and less food getting caught in the embrasures.

Third, the porcelain is better supported. I know PFM crowns are being used less and less, but if the cut back is done im-properly on a stock abutment, you are going to be much more likely to get a porcelain fracture in the future. The wider base of custom abutments helps support the restoration better, and will lead to much better longevity. Even zirconia crowns can fracture. Having a proper base is good for them too.

If you do it properly and have an implant level impression, the crown margins can be made perfectly in the lab, and they can be verified in the lab. In my opinion, taking an implant level impression, having the custom abutment made, placing the abutment, and then taking a traditional crown and bridge impression of the abutment puts the patient through extra impressions they don’t need, and then the restorative dentist is having to capture accurate implant margins which is not an easy task. Tissues are delicate sometimes in the esthetic zone. You could be setting yourself up for recession and an exposed margin by packing cord to capture your margin.

Professionalism, Integrity, & Quality

6565 South Yale Ave. Ste. 1008Tulsa, OK 74136

The patient had external root resorption on tooth #9. The patient was involved in a football accident several years prior, and had root canal therapy at that time. The patient developed external root resorption, and the tooth was given a hopeless prognosis. The tooth was extracted and an im-mediate implant was placed with a custom healing abutment. After healing the tooth was temporized, and a gold hue Atlantis abutment was placed and an all porcelain crown. The patient had an excel-lent cosmetic result. The crown and abutment were fabricated by International Dental Arts.

Case Study

Dr. William B. Wynn, IV

Services Offered By Eastern Oklahoma Periodontics

• Implantplacement • Hardandsofttissuegrafting which includes implant site preparation • Cosmeticperiodontics • Treatmentofperiodontaldisease

(918) 492-0737

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