What Some People Do Is Put Me In Scored

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Sounds like a great idea to do that so

what some people do is put me in scored

on the abutment screws before they

torque it down as a little bit of fact

you know what if you know the best way

to avoid problems does not have it so

utilizing a comical connection would

preclude that but if you’re a trial

abuser and want to continue to use trial

oh I think that would be a great way to

do it

what driver to use for interactive they

have their own drivers so there are

tools to to get that carried carried

into it so when you have your kit of the

regular spectra system or standard kit

you will have to buy different tools now

the screw you still use the 1.25

millimeter hex can you use sirak guide

to with interactive noble active implant

guide driver so the question is for a

system called Sarah guy – if your

asterik and Galileo’s user this is a

Milled chair sight surgical guide system

that we use you definitely can use a

chair guy to is interactive you want to

purchase the nobel replace not know

metal active but the nobel replaced

conical connection guided mount that’s

quite a mouthful

and so the nobel replaced conical mount

fits the interactive and fits the first

two tubes in ceará guide to cerci – as a

small medium large guide tube just buy

the nobel replaced conical the smallest

one is called the NP narrow platform and

the RP is the 4.3 don’t get the WP or y

platform it doesn’t fit cirrus guide to

here’s that question is the interactive

implant placed at the bone level or

below the crest GU this is a good one to

talk about so I have always been a fan

of placing my implants between a half a

millimeter and a millimeter and Carl

mesh had said that we can expect between

zero and two millimeters of bone loss on

gray and brown mountain

any implant we place so why don’t we

just get going on that place our

implants a little sub crystal and if we

happen to lose bone we’re still below

the crest now with platform shifted

implants the name of the game is to

actually get bone growing over the top

of your implant so you know if you’re

super crystal you’re never going to get

bone growing over the top of it right so

so I place my implants a millimeter in

I’m actually going a little more like a

millimeter in half and I heard someone

lecture who had a really good point they

said that cortical bone has very little

blood supply the medullary bone has a

lot so why would you want to put your

implant platform in a sort of cortical

bone that could resorb once you stick in

the medullary bone and let that bone

grow over the top and then come back in

with a bone profiler and take it out

so I’ve seen guys putting implants in

two to three millimeters sub crystal

which I think that’s a little much but

I’m definitely in the one millimeter to

1.5 especially with platforms shifted

implants like the interactive do you

ever start with a full diameter healing

abutment when using a platform switch

final above it good question you know

one thing that a lot of people have

noticed is that sometimes some of

implant direct implants healing

abutments are a little wider than the

implant that you’re placing which can

get caught up on bone at your sub

crustal what I did and this is not

advocated by of lad direct this is just

me what I found with a lot of the

implant direct implants is the abutment


were you know let’s all the same size

with the exception of the three

millimeter so what I did was I bought a

bunch of 5.7 millimeter Kealing

abutments that is crank them down on all

my implants three point seven and above

to start forming the tissue I got the

oscillating we all go through evolution

Center practice of seeing our work come

back and whatnot I’m going back to I

know it sounds horrible and don’t think

that I’m a horrible person but I’m going

back to to stage I am doing a lot more

just putting a healing cap on getting

primary closure coming back in a month

before I’m going to restore and putting

an anatomic healing above it so I use

something called a contour healer if you

go to contour healer calm you’ll see

these these are beautiful and so let’s

do is open up the tissue do an ethically

position flap or maybe do a little

ancillary self tissue grafting and of a

month later I’m getting these beautiful

tissue profiles but yeah I mean back in

the day act certainly did start with a

big full diameter healing above it do

you make custom abundance with your core

use a lab I personally use sirak to do

that custom abutments I love doing it

chair side sometimes I got to be honest

with you and they do take a long time

and sometimes if I’m just lazy for lack

of a better word I’ll have a lab make

custom abutments I gotta say a custom

direct makes a titanium custom abutment

for Vegas 160-170 that’s hard to beat

they don’t have sir coney abutments yet

so it’s really it’s up to you if you

have a chair side CAD CAM machine that

does it I think that’s a great way to go

however I I do make myself any tricks on

getting the driver tool loose from the

future mount from the picture mount

seems to lock in if I have into

tightening a past 15 years and

centimeters I’m using legacy two and

three I’m always afraid I’m going to

damage the Australia with a wiggling OH

this happens to all of us so yeah cold

rippling water

welding can really kind of freak you out

what you can do is wait the heat in the

mount will sometimes loosen up that

connection what I do is I know it’s

freaky with the wiggling is I just get a

pair of forceps or whatever and I’ll

just grab a hold of missing some tissue

scissors and I’ll grab a hold of the

abutment and I wiggle it laterally so me

feel definitely not buckling bully and

usually I can get out of one time I

remember man I really cold welded that

thing and I could not get it off and you

know I did immediate temporization so I

went ahead made a temporary on it but

usually just grab a hemostat that’s the

word I was looking for not tissue


grab a hemostat and if you wiggle I can

just give it some time maybe go tell the

patient to go you know out eat lunch or

do whatever and the heat from the mouth

should take care of it what do you use

the most retained or cement able if I

had my way I would only do screw retain

I just I had problems with cement sepsis

I’ve taken post off bite wings and I

thought I’ll to cement out and then when

the implant failed I could see it so if

I had my way I would do screw Thane that

being said you can do screw attain and

everything so about 80% screw retained

in the posterior about 50% in the

anterior a question here have you had

any issues developing emergence profile

in the molar areas using the interactive

I haven’t but that being said I do have

a tendency to place my implants deeper

than most

so remember emergence profile is all

about developing that runway that’s

three to four millimeters between the

implant platform and the cej of your

future crown so I personally have not

had a problem with the interactive I

don’t really see how

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