Hi I delivered a crown and I see this connection between fixure and implant crown . Is this because of too much height of gingival tissue created due to use of too long healing abutment ?Should I remake this implant crown? What can be possible negative outcomes of this ? Contacts are within normal limits and crown is properly seated all the way down.
Thank you
That just looks like a poor abutment design. The healing abutment is only there to shape/form the tissue for proper emergence profile. Aside from the fact that this looks like the abutment might be the wrong platform size for the fixture it is just poorly designed and has nothing to do with the height of the healing abutment used. I would check the authenticity of the components and remake it with the proper parts.
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Thank you for your explanation!
I know with Zimmer, for example, a 3.5 platform component will engage and seat on a 4.5 fixture but it will create a gap at the implant-abutment interface similar to what is present here. Aside from verifying the proper parts I would suggest a different lab that understands the importance of emergence profile…
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My suggestion is to change it up so that you have a wider abutment and not such a “lollipop” type of crown that will very susceptable to food trapping under the crown due to the lack of a nice emergence profile.
The contacts are not the main issue here as the food will trap on the lingual
BTW, I’m using 100% tissue level Straumann except in the anterior region of the mouth
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As along as you always account for the soft tissue thickness I doubt you will regret your decision to use the Straumann TL. This is coming from someone who spent over 10 years trying all of the new designs and landed back on the original Straumann TL.
As this image shows the Straumann TL will completely eliminate the possibility of such a toadstool crown by incorporating the emergence profile into the fixture…
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I have no idea what product is in the 13 area as I did not place it…
Also patient came back today with loose crown . Its just few days back I screwed it in. I will make a new one at a different lab . Also I am interested in tissue level implants and will get in touch with my implant rep. Thank you everyone for your input.
this mushroom crown usually happens when you write your lab slip requesting a stock/pre fab abutment without giving the lab a stock abutment from your implant system. Then the lab will use whatever they have on hand. most of time is aftermarket and usually screw and abutment does not fit your implant perfectly so crown prone to become loose. for your case, they picked a stock abutment with a 3 or 4mm collar. they make the crown high to avoid pressure on gums which will only feel uncomfortable for patients during deliver. I usually provide a OEM stock abutment if i want to use stock instead of custom abutment. your mushroom crown is more of a hygiene problem.
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TL implants are good because platform is way above biological width. so chance of bone loss is very low due to micromovement between crown and abutment. but mostly TL implants are for your posterior teeth. i doubt any patient would accept an anterior TL implant.
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Thanks for the explanation!
usually i use stock abutments for posteriors and custom abutments for anteriors.
stock abutments are cheaper lab fees while custom abutments are more expense lab fees. so in keeping your overhead low. you have to place implant perfectly or close to perfect for posteriors which usually is not difficult. then you can use stock abutments and lab does it digitally and mill a crown for much cheaper price than custom abutments. custom abutments involves more manual labor hence more expensive. also the implant system i use the stock abutments comes w/ the implant. buying together is cheaper than buying separately. and using OEM stock abutments and screws guaranties perfect fit.
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Like most others I generally reserve the TL for posterior sites due to esthetic concerns but fundamentally it is just a superior design…
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Thank you for the link Dr Scotty. !
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