That Would Be Any Different

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and maybe I’m missing the point here how

that would be any different from any

other implant maybe with the amount of

conical connection but I personally have

not found that let’s see here in general

do you prefer the internal hex or the

conical oh you had to ask me that I

don’t know to be honest with you I know

the conical is good for me it’s good for

my patients it’s it’s the way that

everyone is going I the majority of my

implants have an internal hex I do like

that tactile sensation of an internal

hex when I’m placing that abutment and

it’s kind of weirding me out with

placing the abutment in the comical

connection and feeling that sort of

pushback but I would have to say that

going forward I am ordering all conical

and I’m just going through my stock of

legacies so I personally prefer the

conical connection

can you call well the interactive

abutment to the implant by over torquing

and what’s recommended torque value well

be a screw recommended torque value is

thirty when I’m placing an implant in

the bone I like to stay between thirty

and fifty Newton centimeters and

absolutely you can Colwell be

interactive just like any other implant

if you torque it too much it’s going to

it’s going to be an issue for you and

again I think that a cold welding would

be a little scarier with a conical

connection versus an internal X because

there is greater surface area and a

greater tendency to do it I showed

before an image of the multi torque

wrench from implant direct I highly

recommend that you only use a ratchet to

index your implant but in general try to

use a multi torque wrench and not to

exceed 60 Newton centimeters of torque

when you’re putting an implant in if

your implant is not going down it keeps

disengaging at 60 take a step back and

ask yourself what can I do to my off the


need to make this implant go down so do

I need to open up it bigger go to a

bigger drill size use a Kressel bone

drill or use a tap for maybe a different

company to get that in there if you’re

using accurate scan body to fabricate an

implant crown will there be a difference

in the height of the scanned body versus

a tie base do to the final feeding of

the tapered fit a great question yeah

you got to make sure that your tie base

or scan post your scan body is down all

the way and so go ahead and take a

follow up x-ray there shouldn’t be a

difference in the ACLU’s or cervical

height of the scan body versus the tie

base into it because that would be a big


so yeah just make sure that you’re down

all the way make sure you take make sure

silhouette photo of person riding on horse under twilight sky

you take a next way to make sure you’re

seated what happens when you go back to

put in the healing cap and the bone is

too high to screw it completely in well

now a healing calf let’s talk about the

difference create queue and cap and

healing above it so it’s a healing cap

it’s going to be a little smaller in

diameter than a platform shifted implant

so if your implant is five millimeters

sub crystal you should be able to get

the healing cap on now healing a button

is another story a healing abutment may

be wider than the implant you’re using

if that’s the case take the healing cap

put it down off the implant and screw it

in different companies do have types of

birds called bone profilers you could

try to be very gentle and use the

crustal bone drill what I have done and

this is just me August your buddy

talking is not advocated by implant or

anyone else

I’ll buy the healing cap on I like to

use a carbide chamfer

I know patterns themselves Andrew

Pearson it’s by God I forgot the name of

it but if you look at any of my posts

or up on digital enamel they have it’s

my finger I’m certain my finger makes it

and then make sure you put that healing

cap on and then I’ll just run that with

a lot of water and just start beveling

that excess bone so I can get the

healing cast down what do you think

about osteo densification like Bruce

over oh my god I get a case my first

case the other day with it I think

osteo densification is awesome and it’s

the way to go those of you that don’t

know what the Versa Brewers are verse

numbers are run in Reverse after you

start with a pilot and they compress the

bone like a rotary osteotome instead of

cutting away it’s freaky you can see

these post-op x-rays where the implant

has like a zone of gritty opacity around

it it’s really awesome I think it’s

awesome I think it’s definitely the way

to go I would worry about osteo

densification in d1 bone because we’re

already dealing with very dense bone but

obviously we would use it in d1 bone but

gosh in d3 or d4 bone I would be all

over that

a non an on tap implant and d1 bone

engages bone only at the edge of each

thread a ratchet and reverse will break

hold well in a fixture amount Hey there

you go yeah definitely a unscrewing the

screw using a ratchet in Reverse would

would do that

my only thought would be how much you

cold well do that if you exceeded 100 or

150 Newton centimeters of torque which

you bend the fixture mount itself but

definitely cold welding problem and

certainly freaks me out from time to

time to restore posterior implants 19 20

blue body water

or 14 or 15 do you splint them great


I only splint implants if I’m using

short implants or someone has like

really really crappy bone like D for

bone so if I’ve got like three ten

millimeter implants I’m not going to

split them but I’ve had a couple of

eights and sixes I’m definitely going to

want to split

if you split them you know it’s more a

matter of personal preference

I know patients want their old teeth

back and they don’t like implants clear

splendid but if you’re dealing with a

bone density issue or a short implant

issue then I play

I like scanning scan bodies like

yourself CAD d2 you have a preference of

scanned bodies types of manufacture

great question I’m limited I’m a seer

accuser so with my scanner you might

have to use the Sirona scan bodies but

you know there’s lots of different

companies out there I know three eyes

navigator system I guess people really

like that as far as the scan body goes I

know my indirect is coming out with a

line or has a line of scan bodies that

you can use to send a custom direct I

think it really depends on the system

you’re using and the manufacturer a good

question here hey August so are you

saying there was less screw loosening

with conical connection yes I think that

that was the gist of the different

studies that a conical connection

platform shifted implant had the least

amount of screw loosening do you like

rotary expanders I do like rotary

expanders especially I don’t do full-on

lateral lift I gotta be honest today I

just haven’t taken a class on how to do

them but I love summers less than

interim the less than I use rotary

expanders a lot I’ve seen it used like

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