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- If necessary, first verify diameter of prosthetic top of implant and flair of healing abutment.
- Remove healing abutment with proper size driver and immediately place pick-up impression coping.
- Partially hand-screw the guide pin into the implant. Rotate impression coping until you feel the hex engage, then tighten the guide pin by hand until snug. Do not over tighten guide pin.
- Mark top of guide pin with Pressure Indicating Paste (PIP). Rotate impression tray (stock or custom) into place, then touch guide pin.
- Make radiograph of implant/impression coping junction. (The film should be positioned parallel to long axis of implant with patient holding film with hemostat.)
- From developed radiograph, verify seat of impression coping, then tighten guide pin with the proper size driver.
- While an assistant develops radiograph:
- Place holes in impression tray with acrylic bur. (Hole should be 5mm in diameter and in direction of path of insertion of impression.)
- Test tray in patient's mouth to verify position. (The screw should protrude through the tray.)
- An assistant paints tray with adhesive, places wax over hole, allows to dry.
- Syringe medium- or heavy-body impression material around impression coping, then fill tray with same material. (We prefer vinyl polysiloxane or polyethers impression materials.)
- Seat impression tray and allow guide pin to protrude through wax on tray. Once impression tray is in place, have assistant remove wax over guide pin and wipe with cotton swab.
- When impression material is set, loosen guide pin with proper size driver.
- Remove impression tray. Impression post(s) is picked-up in the tray.
- Inspect impression, then place healing abutment back on appropriate implant.
- (If impression is inadequate then retrieve impression coping from impression and repeat.)
- Send impression with guide pin and radiograph to our laboratories.
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- If necessary, first verify diameter of prosthetic top of implant and flair of healing abutment.
- Remove healing abutment with proper size driver and immediately place transfer impression coping.
- Partially hand-screw the guide pin into the implant with impression coping driver. Rotate impression coping until you feel the hex engage, then tighten the guide pin impression coping driver until snug. Do not over tighten guide pin.
- Make radiograph of implant/impression coping junction. (The film should be positioned parallel to long axis of implant with patient holding film with hemostat.)
- From developed radiograph, verify seat of impression coping, then tighten guide pin with impression coping driver.
- An assistant paints tray with adhesive, and allows to dry.
- Syringe medium- or heavy-body impression material around impression coping, then fill tray with same material. (We prefer vinyl polysiloxane or polyethers impression materials.)
- When impression material is set, remove impression tray and inspect impression. (If impression is inadequate, retrieve impression coping from impression and repeat.)
- Unscrew impression coping, then place healing abutment back on appropriate implant. (If more than one in mouth, place one at a time.)
- Return transfer coping into the appropriate position in the impression. If there is more than one coping, be sure to place each one back into the correct tooth position, as there may be a slight difference in each impression coping.
- Once coping is back in the impression, check that it fits snugly. If there is any movement, the impression must be retaken.
- Send impression with coping pin and radiograph to Dental Art Laboratories.
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- Verify rotation of abutment on implant master model. (We will either mark the buccal or the lingual of the abutment so that you can match the correct rotation in the mouth.) If there is more than one abutment, we will also number the abutments; however you must place the abutments in their respective locations.
- Remove healing abutment with proper size driver and immediately place appropriate abutment, making note of the markings on the buccal or lingual. (If there is more than one abutment, we recommend placing one at a time).
- First, partially hand-screw the abutment screw in place, using the appropriately size driver.
- Next, rotate the abutment until you feel the hex engage; checking the rotation of the abutment to ensure it is in the same position as on the master model.
- Tighten the abutment screw by hand until snug. (Do not over tighten abutment screw.)
- Temporarily place the respective crown on the abutment to check proper rotation. If rotation looks good, remove crown and set aside for final cementation.
- Take a radiograph of implant/abutment junction. The film should be positioned parallel to the long axis of implant, with patient holding the film with a hemostat.
- Verify seat of abutment from developed radiograph. If seated, tighten abutment screw with wrench to recommended specifications listed on your copy of the implant record that was sent with the case.
- After abutment has been placed, adjust crown the same as you would with your other crown and bridgework.
- Before cementing crown, place gutta-percha in the screw access hole. Do not use cotton, as this will breed bacteria, and do not over block-out. Cement the implant crown using the same procedures as other crown and bridge cases.
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