[Diagnostic / Planning]  Location-- revisited

Hi :

 I have made some modifications re location and size .

Note : the angulation of natural tooth at #25 . Matching this  for implant at 24 creates less than ideal bone support , but occlusal access hole and prosthesis may be better.

I have proposal for 4.5 mm and a 4.0 mmx 10 , with different angulation, which changes access hole location. If I choose more parallel bone support, do I need to use angle abutment , or cement retained crown ?

Thanks for revisiting this case .

by Madeson Basie at Fri, Jun 30, 2017 2:28 PM

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Ho-Young Chung Replied at Mon, Sep 25, 2017 2:40 PM

Hi Madeson,

It looks like you have adequate bone to go screw-retained possibly by using an angled driver for the final crown(s).  Make sure you leave 2mm of buccal bone either way and don't get too close to buccal plate at the apical end as well.  

Ho-Young Chung

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Anand Choubal Replied at Thu, Jul 6, 2017 6:48 AM

Hi Madeson, not sure if I'm experienced enough to advise you but since I had a similar case, I thought I would chime in.

My patient was a 60 yo male who was primarily interested in functionality and longevity.  He had a very low smile line and little concern for esthetics.

Single tooth #24 replacement and we decided to do screw retained zirconia with the acces hole coming out the facial of the crown.  Resin plug looks ok but not visible.  We were further motivated by retrievablility due to his extremely high occlusal forces and likely breaking/loosening of abutment screw.

I would personally talk to Tony and see what he thinks but my vote would be screw retained - maybe angled screw channel will allow for more esthetic positioning of hole?