Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case

Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case

Case Study by: August de Oliveira, DDS

This case really covers all that goes into replacing a fractured tooth. This patient came in with

#18 fractured just above the gum line. Whatever was left was decayed. Removed and placed

MFDBA and a membrane. Patient healed up well.


Planned in CEREC and Galileos for #18. Again, leaning mesial per the Curve of Spee and lingual

per the Curve of Wilson.

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Also in the works is the IME Sirona Punch kit. There are Small, Medium, and Large punches that

correspond to the block sized of CEREC Guide as well as the two sized sleeves we have in the

Implant Direct Sirona Guides. The Large and Medium fit Nobel, but the small is a little too big for

the Nobel sleeve. These punches have a longer shank so that they can work with most guides

without an extender. They will come in a bur block with six punches (2 of each) and these will be

ready at the same time as the handles. Send me an email at [email protected] if you want to

be included on the list and for which products. ImplantsMadeEasy.com launched January and has

a shopping cart.

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mailto:[email protected]


Smooth procedure. I know it looks like we are lacking attachment on the buccal but the tissue is

just a little flabby around the implant. Also in #18 and #31 it is just tough to lateralize the tissue

due to the ascending ramus. I only had a HA so I used it, but normally I just use SBM implants,

and only use HA in D3 and D4 bone.

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Finally, the graft was only 8 weeks out and still felt soft, so I probably only got about 20 Ncm of

torque. The tongue exerts 25 Ncm so I did not want to go with a healing abutment. Also, I

wanted to see if I could get some more attached tissue to granulate over, so I went with a cover

screw.

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Case completed with a custom titanium abutment from Implant Direct's CustomDirect! Note the

just slight sub gingival margin and look at the length of the transgingival portion! That’s a deep

subgingival platform. I just love doing custom vs. stock!

Dr August de Oliveira graduated from dental school in 1997 from the University of Washington

and completed his General Practice Residency in Los Angeles in 1998. Dr de Oliveira has been lecturing

on 3D technology since 2004, when he started as a CEREC Basic trainer. Since 2008 he has been involved

with Implant Direct’s R and D department developing Guided Surgery Software and Hardware and testing

their CAD Milled Bars and Substructure Department. Dr de Oliveira has written two books on

Implantology: Implants Made Easy and Guided Implantology Made Easy. He has been involved with beta

testing Sirona’s Sidexis Program, as well as developing the Opti and CEREC Milled Surgical Guides. Dr de

Oliveira lectures nationwide for Sirona on the Galileos Cone Beam system and Sirona Guided Implant

Surgery. He also teaches for Implant Direct at their Las Vegas Educational Facility and with the Engel

Institute in Charlotte NC. Dr de Oliveira lives and practices in Los Angeles CA.

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Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case

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Transcript of Out With the Old, In With the New: CustomDirect Titanium Abutment and Legacy Implant Case