Unable to seat Hiossen Impression Coping: Recommendations?
Any Hiossen users out there? I tried seating my impression coping on 4.5mm diameter Hiossen implant but couldn’t get it to seat all the way. It usually takes a few tries to get it to seat, but this time I tried for like 45 minutes. When I uncovered I was able to get a 4x5mm HA abutment on it with no problems even though it was subcrestal. I re-appointed the patient and told him I will have my Hiossen representative come in to help, but mentioned I may need to remove more bone. Any recommendations?
19 Comments on Unable to seat Hiossen Impression Coping: Recommendations?
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Miguel Martinez
12/20/2019
Hello. I place these at an office. Make sure your not using ‘M’ impression coping, for mini 3.5 implant.
Hal Wilson, DDS
12/20/2019
You probably need to use the bone profiler. You can get them from Hiossen. This will eliminate your problems.
Carlos Boudet, DDS DICOI
12/20/2019
I hope you took a radiograph to verify seating which you did not post. If not, that is the second thing you need to do when attempting to seat impression posts or healing abutments. The first is to verify you have the correct component(part).
Also be prepared when exposing the implant and have the bone profiler ready as was suggested.
It should never take you that long to seat either of those components.
Dr D
12/20/2019
Please post an IOPAR to enable a clear view.
Also if it’s sub crestal, it is likely that some bone is interfering with the taper of the impression post placement.
Try a cement retained restoration instead.
Dr. Gerald Rudick
12/20/2019
Please post photos and xrays...what you are stating makes little sense......sorry!!!!
Flavio
12/20/2019
I use Hiossen as well. What size impression coping are you using?
If you are using 5mm it may binding against the gingiva. Instead use 4 x 14 (the longer) coping. It should work since you said 4x5HA seats.
Good luck!
Flavio
12/20/2019
In addition check to see if any gingiva has grown on top of implant margin thus preventing seating.
Maybe the HA was not seated completely due to bone impingement or HA became loose.
Dr Indraniil
12/20/2019
Hi,first things first hope you are using a new impression post.Many of us including me sometimes use copings more than once and old ones sometimes don't fit.So try a new piece.2nd thing is place an abutment and see if it still rocks.If it does then you may have damaged the implant while removing the bone around it(which is hard to fix).If the abutment fits then that means the coping isn't seating as it's flare must be catching on either some bone or gingiva.Hope I helped.Gopd luck
Ed
12/21/2019
The impression transfer is being prevented from being seated by bone surrounding the I/A interface. You will need to anesthetize and use the bone profiler instruments. You will need to use the 5.5 mm profiler. Be sure to use no more than 1k RPM with plenty of chilled sterile saline irrigation.
JM
12/22/2019
Bone profiler to the rescue! Typically if the implant is subcrestal when uncovered I will the Hiossen bone profiler that corresponds to the implant diameter. This will prevent problems when placing the impression pin a few weeks later.
Montane
12/22/2019
Bone profiler to the rescue! Typically if the implant is subcrestal when uncovered I will the Hiossen bone profiler that corresponds to the implant diameter. This will prevent problems when placing the impression pin a few weeks later.
oralsurgeryjj
12/25/2019
Bone profiler will do the trick definitely.
Pitiful hacks on emergency situation:
If you need to wait for some time to get the profiler, and if the patient cannot wait for several reasons, try using countersink drill. Start with slightly smaller diametered sink drill to put it in the internal connection part of the fixture. The countersink drill of Hiossen has non cutting surface on tip, which does no harm on fixture when drilled. Put the drill deep around the fixture platform and drill it with 100 rpm, no irrigation. Rotate and stir the handpiece and drill as if you manipulate joystick in old arcade. That will enable you to cut crestal bones on the platform. If can see ground bone on the sink drill cutting edge, try with larger diameter.
Joe
12/26/2019
Take an xray. You have bone grown above your implant that isnt letting your components fit all the way in.
S. Hunt
12/26/2019
I have never encountered a case where the impression coping cannot fit, but then I havent placed a huge number of fixtures.
I cannot figure out how bone can grow over the implant platform unless the fixture is placed not only subcrestal but deep subcortical as well.
Should bone grow over the platform in the recommended 0.5 to 1.0mm subcrestally placed fixture, shouldn't it be a case to rejoice because all fixture threads are in bone?
No part of the healing abutment or impression coping rests on the the fixture platform. So if the healing abutment can seat , there should be no interference in the seating of a correspodingly sized coping?
oralsurgeryjj
12/28/2019
It happens quite often for me in case of internal type fixures. I prefer 1~2mm subcrestal deep for internal type, since saucerization after prosdontic procedure happened a lot.
When supracrestal periostium tissue heals so quick(amphibian-like patient!!), bone can be grown up around the platform.
In order to prevent bone overgrowth, I prefer to use 2mm height cover screw for internal type fixture. No need to hassle over finding fixture in the bone on 2nd surgery.
I sometimes use 2mm height healing abutment for large defected bone grafts. It gives tenting effect of soft tissue and easy 2nd surgery as well as prevention of bone overgrowth.
This is a case I have done several months ago.
https://www.instagram.com/p/BwqRLJSjTXS/
Dr Bill Woods
12/27/2019
Occasionally bone will grow over the platform edges or thick KT will impinge on placement. Bone can be tough to remove without dinging up the periphery and compromising a sealed seating. I don’t use these but make sure the size and abutment accommodate each other, as well as screw size. I use Nobel and there are differences in the tapered and active components. Every case is different. Please post a pic. Happy implanting.
Dr Bill Woods
12/27/2019
In addition to my last, I have also seemed to have almost no difficulty in placing an implant just slightly supercrestal . I know there are benefits and risks to where they are placed but this seems to limit bone issues. Then I’m limited to mostly tissue issues, which may be limited to removing a small collar of fibrous tissue around the collar if needed.
Colorado Denture Speciali
2/12/2020
Please join us and attend one of the local FREE Hiossen AIC Events in your area. They are hands on 7hrs. of CE & Lunch..
So yes there is such a thing as a free lunch ?
Colorado Denture Speciali
2/12/2020
Please join us and attend one of the local FREE Hiossen AIC Events in your area. They are hands on 7hrs. of CE & Lunch..
So yes there is such a thing as a free lunch ?
