implants international magazine of oral implantology

research I abutment and then attach the crown to the abutment withacrosspinorinsomeotherremovablefashion.The abutment will alter the crown–root ratio significantly, thereby decreasing the forces on the abutment screw and decreasing the likelihood of the abutment screw loosening. Retrievability, using a cross pin or other method, will facilitate access to the abutment screw shoulditloosen. Figure2showssuchacaseinwhichthecrown–root ratioistoolargeforadirect-to-fixturecrown.Thiscase has the added problem of a regular-diameter implant with a wide-diameter crown, which would tend to in- crease the possibility of the screw loosening further. A wide-diameter implant would probably have been betterhere. _Componentry mismatch? The case presented in Figure 3 is very unusual. A ra- diograph was taken to verify seating of the impression copinganditwasobservedthatthecopingwasseated halfway down the external hex and could be placed no farther (Fig. 3). It was clear from the radiograph that therewasnoboneorsoft-tissueinterference.Different impression copings were tried but the result was the same. The conclusion that the author finally reached wasthattheremusthavebeenamismatchbetweenthe diameter of the external hex on the fixture and the di- ameteroftheimpressioncoping.Oncethisconceptwas accepted, a laboratory impression coping was fabri- cated to allow for this and the coping seated correctly, with treatment proceeding uneventfully. The crowns havebeeninplaceformanyyearswithnoproblems. Amismatchindiameterbetweentheexternalhexof the fixture and the diameter of the impression coping appearstobetheonlyexplanationforthesecases.How- ever, the author would be interested in other explana- tions. _Implants and bisphosphonates Inthepast,itwasunderstoodthattherewasaprob- lemwiththeuseofbisphosphonatesandalveolarbone. A patient taking Fosamax was referred for implant re- placement of the missing tooth #11. The fixture was placedbyaperiodontist,andafterasuitablewaitingpe- riod was restored by the author. All procedures were routine and uneventful, and the patient was pleased withtheresult.Aboutoneyearafterthecrownhadbeen placed, the patient rang, saying that the “implant had moved”. This generally indicates that either the fixture has failed or the abutment or crown has loosened. The YOUR ADVANTAGE! THE 2 IN 1 CONCEPT: Conical connection - with anti-rotation hex! DEALERSWANTED! Special Promotion for your start into the IMPLA system: 30 implants, abutments, gingiva formers, lab analogs, transfers and surgical kit! Be ahead of your competition! Wide range of trainings available for you and your team Controlled German Quality Great results + maximum security = satisfied customers Optimized thread design improved primary stability in softer bone as well Platform switching for improvement of the soft tissue attachment Microstructured, high-purity surface for optimal cellular adaption and safe ossification Emergence profile for excellent aesthetic results and time-saving Conus + hex = high stability + sealed micro gap Red-white aesthetics - sealed micro gap This shield against germs sup- ports the preservation of papilla, margin and marginal bone The new IMPLA hybrid connection Promotion Code: P121154 Sign up for the exclusive IMPLA Newsletter: http://sdent.eu/newe Scanme. al conicC OURY ti-rtion - with anonnecal c HET!GEAANTVVAAD x!tion heotati-r EPTCONC1IN2HE :EPT WANTED! DEALERS ALEALERSWANT tttachment tissue aof the sof temenvoor imprf chingorm swittfPla x =onus + heC he neT and time xor ef Emer his shield against gerT sealed micr Red-whit tiononnecybrid cA hw IMPLhe ne lab analogs 30 implan o the IMPLA sytin ecial PSp ving-saand time esultst aesthetic rellencx ofilee prgencEmer -ms suphis shield against ger o gapsealed micr e aesthetics -Red-whit tion omotion CrP ical kgsurandersansf, trlab analogs a fiving, gts, abutments30 implan em:sto the IMPLA sy orffoomotionrecial P ode: P121154omotion C it! TED!T ical k ,ormersa f em: tour staror y eller bone as wtin sof yy stabilitimared prvoimpr ead designthr edptimizO o gapsealed micr y +high stabilit e ossaf or optimal cf high-purit icrM gmar ts the prpor his shield against gerT eaGr» onC» ide rW» e ahead of yB tionsificae os ellular adaption andor optimal c efacy surhigh-purit ,edturucostricr inal bonegmarin and tion of papilla,aveserts the pr ms suphis shield against ger y = saitesults + maximum securt rea yualitman Qerolled Gtron ailable fvainings aange of tride r ompetition!our ce ahead of y omerstisfied custy = sa eamour tou and yor yailable f canmeS e.eu/newtttp://sdenh :erslettIMPLA New eclusivxor the en up ffoSig e AD