Page 1

Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case Case Study by: August de Oliveira, DDS

This case really covers all that goes into replacing a fractured tooth. This patient came in with #18 fractured just above the gum line. Whatever was left was decayed. Removed and placed MFDBA and a membrane. Patient healed up well.


Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case

Planned in CEREC and Galileos for #18. Again, leaning mesial per the Curve of Spee and lingual per the Curve of Wilson.

2|P a ge


Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case

Also in the works is the IME Sirona Punch kit. There are Small, Medium, and Large punches that correspond to the block sized of CEREC Guide as well as the two sized sleeves we have in the Implant Direct Sirona Guides. The Large and Medium fit Nobel, but the small is a little too big for the Nobel sleeve. These punches have a longer shank so that they can work with most guides without an extender. They will come in a bur block with six punches (2 of each) and these will be ready at the same time as the handles. Send me an email at augustdds@gmail.com if you want to be included on the list and for which products. ImplantsMadeEasy.com launched January and has a shopping cart.

3|P a ge


Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case

Smooth procedure. I know it looks like we are lacking attachment on the buccal but the tissue is just a little flabby around the implant. Also in #18 and #31 it is just tough to lateralize the tissue due to the ascending ramus. I only had a HA so I used it, but normally I just use SBM implants, and only use HA in D3 and D4 bone.

4|P a ge


Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case

Finally, the graft was only 8 weeks out and still felt soft, so I probably only got about 20 Ncm of torque. The tongue exerts 25 Ncm so I did not want to go with a healing abutment. Also, I wanted to see if I could get some more attached tissue to granulate over, so I went with a cover screw.

5|P a ge


Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case

Case completed with a custom titanium abutment from Implant Direct's CustomDirect! Note the just slight sub gingival margin and look at the length of the transgingival portion! That’s a deep subgingival platform. I just love doing custom vs. stock!

Dr August de Oliveira graduated from dental school in 1997 from the University of Washington and completed his General Practice Residency in Los Angeles in 1998. Dr de Oliveira has been lecturing on 3D technology since 2004, when he started as a CEREC Basic trainer. Since 2008 he has been involved with Implant Direct’s R and D department developing Guided Surgery Software and Hardware and testing their CAD Milled Bars and Substructure Department. Dr de Oliveira has written two books on Implantology: Implants Made Easy and Guided Implantology Made Easy. He has been involved with beta testing Sirona’s Sidexis Program, as well as developing the Opti and CEREC Milled Surgical Guides. Dr de Oliveira lectures nationwide for Sirona on the Galileos Cone Beam system and Sirona Guided Implant Surgery. He also teaches for Implant Direct at their Las Vegas Educational Facility and with the Engel Institute in Charlotte NC. Dr de Oliveira lives and practices in Los Angeles CA.

6|P a ge

Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case  

Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case

Read more
Read more
Similar to
Popular now
Just for you