Legacy 2 does not have a compatible PI

legacy 2 does not have a compatible PI

base outside of implant track so implant

direct does make a tie base for it which

can be used with pressed ceramics

however with milled ceramics a lot of

times you’re going to have to use a

larger implant or use these stocks or

pony above it so if I’m using the

light-blue 3.2 I love to use stock

abundance with them the taper on lower

laterals and lower Central’s as well as

upper laterals there’s not a lot of

flair and the cervical of the teeth that

we’re replacing so that’s something that

if you’re okay with using a stock

zirconia bummin in those cases which

I’ve been I think you’re good one thing

to note the interactive does have a

compatible tie base with most camp

chairs at CAD cam systems that

correspond to the 300 platform

one thing left to note that if you’re

using a mount free design of implants

you can buy these little restorative

packs and these are certain facts are

Kind of cool these are originally

designed for specialists they’re

replacing abutments for their GP so if

you don’t feel comfortable taking a bone

level impression and would like to have

the ease of a snappy cap and having

someone just put that abutment on for

you this is a nice thing to work out

with your specialist if these

restorative packs another side note I

love guided implant surgery and again

come to Vegas or you can see me lecture

nationwide or if you’re on Facebook if

you go to digital enamel or implants

made easy you can see some of my stuff

but I love placing implants guided and

as more and more research comes out the

ability to place your implant through a

surgical guide really increases the

accuracy in the ease of the procedure

one thing that you can’t use when you’re

doing guided surgery and placing

implants through the guide is most fixer

mouths they’re either too wide or they

don’t engage the guide tubes and our

surgical guides so one of the other

reasons why swish to the interactive

implant was because there were guide

sleeves that I could purchase in this

case the Nobel replace conical

connection guided mounts work perfectly

with the interactive and I can place

those through my guide a quick note

we’re running out of time here so I want

to finish this up is to talk about

platform shifting and that really has a

lot to do with our internal connection

and then newer

types of implants we use now I don’t

know if this story is true compared that

platforms switching or platform shifting

was invented by accident a periodontist

was placing implants

came in a small medium and large sized

implant and on those implants small

medium and large type abutments were

available the doctor placed a large

implant but when he went to put the

abutment on for his restoring dentist he

said oh man I don’t have a large

abutment you know what I’ll just stick a

medium above and I’m sure he’ll be good

and one thing I noticed was that the

abutment actually had bone growing over

the implant connection which is what we

would love you know we deal with the

fact that we get some bone reception

around some implants usually to the

level the first thread but gosh if we

could get bone growing over the top of

our implant that would be really great

and that’s where platform switching

comes in hand in hand with platform

shifting is that if you look at the

different studies and we talk about

micro gaps and micro movement the

further we could put the implant

abutment connection away from the bone

the less contact that bone will be with

pathogens that are getting sucked into

the implant and the ultimate version of

moving the internal connection away from

the sides of the implant is the tissue

level implant the tissue level implant

takes that abutment implant interface

and moves it even above the tissue and

so tissue level implants have a


mucosal portion that takes that away

from it you can see in this diagram

where that connection is so on the image

on your left you see an internal

connection and that abutment implant

interface is millimeters away from the

side or on the right you can see an

external bevel where the abutment

implant interface is right on the bone

and we all have patients like this they

are walking implant museums so this

patient has all sorts of different

implants in its mouth

my pet peeve with tissue level implants

are that they’re really tough to restore

in my opinion I like to develop my

emergence profile preferably from the

level of bone up and when it comes to a

tissue level implant we are dictated by

this emergence profile you can see the

progression in platform shifting as we

move through the ages of implantology

with our tri loaded implants having no

platform shifting our internal hex

implant having a little bit more and our

conical connection having the most

amount aplomb shifting you can see in

this cutaway version of the difference

between those two the image on the left

you can see where that abutment implant

interface will interact with bone and

with our conical connection implant we

really have the best of both worlds

we’re really far away from that and we

also have much less than micro gap due

to lateral movement as a side note says

nothing to do with internal connections

I wanted to show the differences between

the types of implants in the way that

thread patterns are as we approach the

if you look at the base of each implants

our threads are fairly aggressive and as

we approach the platform those threads

become smaller and smaller now if you

look at the interactive implant featured

you might see some thread towards the

coronal portion some people believe that

if we do have bone loss and we have a

micro threads that somehow the tissue

will attach to those micro threads and

form a cup or a more stable position of

the tissue around that implants whether

or not that’s through time will tell

just a quick note about internal

connections and indexing and this goes

back to why people really love tri lobes

versus conical connections is that it’s

so easy to index a

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