Achieving Aesthetic Emergence Profile with Straumann Bone Level Implant?

You can order the implant analog amd screw down your temp crown onto it. Then take a ball of putty and push the implant with your temp crown into it (implant first) to capture the cervical third of your temp crown only..let it set. Once this area captured in the impression, remove the temp crown and place your impression coping onto the implant analog located in this putty impression. You will have replicated the soft tissue profile and will be able to prepare acustomized impression coping by injecting flowable composite to fill in the gap of the ceervical third portion of your impression coping. Then remove the impression coping and place it in the mouth. It will push the tissues back to where they were when the temp was in place. Then use your usual impression technique...polyvinyl + putty.. This was taught at a straumann course i took. If not this..then remove the temp in the mouth and inject the light body around the impression coping quickly before the tissues collapse.and adjust out of the mouth to a final shape. Hope this helps Ken

I agree with Ken...you need to use a customized impression component to accurately pick up the soft tissue contours. The temp. crown should be a screw-retained temporary, this will allow you to shape/contour the gingival architecture (I have tried before with a cement retained temporary, but it did not have enough retention to stay in place and the tight gingival tissues actually dislodged the temporary crown that had been cemented with temporary cement ). I only use screw retained temporary crowns during the phase of shaping the soft tissues now. If you use a stock impression component and try to flow impression material into the void space between the gingival shape and the impression coping, it will be a losing battle and you will not have a good gingival shape (the soft tissue cuff will collapse quickly) for the laboratory to give you a final crown with a good emergence profile. Use your screw retained temporary to contour the soft tissue, and a customized impression component for the final impression of the implant position and the soft tissue...and the lab will deliver a good esthetic crown.

Thanks Ken. That was very helpful. Do you use the same method with other implant systems. I have a few Ankylos implants in the anterior region almost ready for the restorative phase. Geoffrey

I require implants for the following 46,47,37,24,11,21. Please can someone advise which product is best. My doctor recommended Bicon and someone said there are other best options. I want to bite and chew my meat and apples and not have future problems and smells/taste problems. Regards

Thanks Ken & especially Melvin, you supplied the missing link, a screw retained temporary is an excellent idea, but what did you use..temp abutment or what. Also what abutment did you use for permanent crown. I have been using Straumann implants for few years now, though bone level training/information is not adequately available.Is it posible to see pics, I am going to upload my clinical photos next week on my clinic website smithandjaindentists.com. I am practising in hong kong, where are you guys based, we could share our knowledge.

Mbali, First of all let me say I have no commercial interest in any company. Now some advice: 1. All implants are similiar over long term, depends on your dentist preference. 2. Bicon is good if the bone height is less. 3. Straumann (iti) is very reliable though expensive but that is what I use in Hong Kong. Another advantage is shorter heling time- 6 weeks compared to 12 weeks minimum for others. 4. I use Noble replace select for immediate extraction & implant cases. 5. There are many other hundreds of companies but I restrict myself to above two as I am very familiar with these two. You could get more info, thru my website smithandjaindentists.com such as case pics, my email etc. Hope this helps