OverviewThe 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
Dr. 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 firstname.lastname@example.org.
About Dr. Bockhorst
After 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 email@example.com.
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).