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WINTER 2012 ISSUE
Table of Contents
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Clinical Tip:
Implant Orientation for Inclusive®Tooth Replacement System Components

video photo essay

Darrin M. Wiederhold, DMD, MS and Bradley C. Bockhorst, DMD

Overview

The Inclusive® Tooth Replacement System features custom temporary components designed to sculpt soft tissue contours during the healing phase. Whether a clinician utilizes the custom temporary abutment or custom healing abutment, the guidelines demonstrated in this Clinical Tip, case examples and accompanying video can help ensure a smooth delivery at the time of surgery.

About Dr. Wiederhold

wiederholdDr. Darrin Wiederhold received his DMD in 1997 from Temple University School of Dentistry and a master's degree in oral biology in 2006 from the Medical University of Ohio at Toledo. Before joining Glidewell in August 2011, he worked in several private practices and as a staff dentist for the U.S. Navy. As a staff dentist in Glidewell's Implant division, he performs implant and conventional restorative procedures at the lab's on-site training facility, and helps support the lab's digital treatment planning and guided surgery services. An integral part of the lab's Implant Research & Development group, he is also involved in training and education on implant surgery and prosthetics. Contact him at inclusivemagazine@glidewelldental.com.

About Dr. Bockhorst

bockhorstAfter receiving his dental degree from Washington University School of Dental Medicine, Dr. Bradley Bockhorst served as a Navy Dental Officer. Dr. Bockhorst is director of clinical technologies at Glidewell Laboratories, where he oversees Inclusive® Digital Implant Treatment Planning services and is editor-in-chief and clinical editor of Inclusive magazine. A member of the CDA, ADA, AO, ICOI and the AAID, Dr. Bockhorst lectures internationally on an array of dental implant topics. Contact him at 800-521-0576 or inclusivemagazine@glidewelldental.com.


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The Inclusive® Tooth Replacement System from Glidewell Laboratories features custom temporary components designed to guide soft tissue contours during the healing phase. Whether you utilize the custom temporary abutment or custom healing abutment, the following guidelines can help to ensure a smooth delivery at the time of surgery.

Aligning the Abutment Connection

The custom temporary components of the Inclusive Tooth Replacement System are designed, presurgically, with ONE FLAT OF THE INTERNAL HEX POSITIONED TOWARD THE FACIAL. During surgery, the final position of the implant should match this orientation. This is accomplished by aligning one of the flats on the implant driver to the facial (Fig. 1, Fig. 2, Fig. 3). If the seated abutment is rotated slightly, it can be removed and minor adjustments made to the rotational position of the implant.

Seating the Custom Abutment

Assuming there is adequate attached gingiva and no grafting is planned, flapless surgery can minimize post-operative discomfort and swelling, leading to higher patient satisfaction. Also, because the periosteum is not reflected, the blood supply to the bone is not disrupted, reducing potential resorption. With the growing popularity of minimally invasive surgery, the use of a tissue punch (or other tools, such as a laser) can make it much simpler to seat anatomically contoured abutments during a flapless procedure (Fig. 4, Fig. 5, Fig. 6, Fig. 7, Fig. 8, Fig. 9). Once adequate tissue has been removed, the custom temporary abutment is seated and the abutment screw tightened to 15 Ncm. A periapical film should be taken, if necessary, to verify complete seating. The screw opening is sealed and the BioTemps® provisional crown (Glidewell Laboratories) is seated with provisional cement. It is absolutely critical that all excess cement be removed and the temporary taken out of occlusion.

In flapped cases, the abutment can be delivered and the complete seating visualized directly. The soft tissue can then be reapproximated and sutured around the abutment (Fig. 10, Fig. 11, Fig. 12).

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  • Figure 1: Flat to facial in flapped case

  • Figure 2: Flat to facial in flapless case

  • Figure 3: Final implant position

  • Figure 4: Case 1 (Tissue Punch): Tissue punch

  • Figure 5: Case 1 (Tissue Punch): Custom temporary abutment seated

  • Figure 6: Case 1 (Tissue Punch): BioTemps crown cemented into place

  • Figure 7: Case 2 (Laser): Laser-assisted gingivoplasty

  • Figure 8: Case 2 (Laser): Custom temporary abutment seated

  • Figure 9: Case 2 (Laser): BioTemps crown cemented into place

  • Figure 10: Case 3 (Flapped): Custom temporary abutment seated

  • Figure 11: Case 3 (Flapped): Flap sutured around abutment

  • Figure 12: Case 3 (Flapped): BioTemps crown cemented into place
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Featured Products and Services

  Inclusive® Tooth Replacement System
Inclusive Dental Solutions
Newport Beach, Calif.
800-407-3379
Inclusive® Tooth Replacement System
  Inclusive® Tapered Implant
Inclusive Dental Solutions
Newport Beach, Calif.
800-407-3379
Inclusive® Tooth Replacement System

  Capture® Impression Material
Glidewell Direct
Newport Beach, Calif.
888-303-3975
Capture® Impression Material

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