Dental Implant: For Part 1 of the same topic, click here.
This is the continuation of the real world case of restoring dental implant discussed in the previous article. In the last article, we have taken impression of the dental implant. From the impression model, the lab made a stone model of the patient’s dentition and the implant. A custom-made dental crown is made based on the stone model.
The stone model consists of the patient’s upper and lower teeth. Upper and lower teeth are arranged accordingly to the correctly articulated patient’s bite.
Commonly the implant crown is either cement-retained or screw-retained. In this case, given the short space between the lower ridge bone and the upper teeth, I decided that only custom-made screw-retained crown can be used in this situation. The type of implant crown is a custom-made screw-retained crown. The implant crown is made in one piece. No cement is needed to secure the crown with the implant fixture within the jaw bone. The implant crown is fixated using a screw.
So the patient comes back in for crown-insertion appointment. I first remove the cover screw. Then I try in the crown and taken the xray images to check for correct fitment. From the xray image, I can see that there is no space between the crown and the implant fixture. This means that the implant crown is fully seated into the dental implant fixture.
After the confirmation from the xray image, I then tighten the screw and use the torque wrench to measure the final torque strength to make sure the screw is secured. A cover material is inserted into the screw access hole. Finally I will adjust the biting surface of the implant crown so to make sure there is at least 30 micron of space between the implant crown and upper teeth. This space is important because when patient’s bites down, the implant does not have the natural ligament around it to absorb the biting forces.
Here is the final image of the implant crowns seated properly in patient’s mouth. It looks and feels like natural tooth.
