Impression Protocol for ZBLC Crown or Immediate Implants
1. X-Ray of Stock Abutment, Custom healing abutment, or Temporary Crown
YES
NO
The X-ray provides essential diagnostic information regarding the precise positioning of the abutment in relation to the implant and surrounding bone. This information is critical for selecting the appropriate abutment and for designing an optimal emergence profile of the final crown.
2. Pre-op scan of Stock Abutment, Custom Healing Abutment, or Temporary Crown
Performing a pre-operative scan of the healing abutment is essential (refer to Tip 1), the scan provides a precise digital record of the soft tissue contours around the healing abutment. This is crucial for designing the emergence profile of the final crown in a way that maintains the exact marginal ridge of the healing abutment and therefore minimizes the risk of disturbing the tissue.
3. Soft Tissue and Scanbody Scan for Final Impression (Full Arch)
Remove the tissue former or healing abutment (refer to TIP 2) and immediately perform a scan of the sulcus to capture the detailed contours before the soft tissue begins to collapse. Following this, proceed with the scanbody scan. This step is critical for accurately designing the soft tissue support and ensuring the optimal emergence profile of Zero Bone Loss Concept (ZBLC) crowns.
4. Scan Opposing (full arch)
A full-arch scan provides comprehensive information about the patient's bite and occlusion. This is essential for ensuring that the implant restoration integrates harmoniously with the opposing teeth and the patient's overall bite, preventing any occlusal imbalances or excessive forces on the implant.
5. Scan Bite (ask patient to bite HARD)
When the patient bites down firmly, it compresses the periodontal ligaments around the natural teeth, replicating the exact occlusal relationship that occurs during normal chewing or biting. This ensures the scan captures the most accurate bite registration, which is critical for designing an implant crown that fits harmoniously within the patient's occlusion.
6. Provide Surgical Report Form to The Laboratory
Implant System: The report typically specifies the brand and type of implant system used, ensuring that the laboratory uses matching components for the final restoration. Proper component selection is critical for a precise fit, which contributes to the overall stability and longevity of the restoration.
Selection of Abutment Type and Size: The surgical report often specifies the type and size of the stock healing abutment or abutments used for tissue former or temporary implant crown. This information allows the laboratory to choose the correct abutment and create a custom emergence profile that matches the patient's tissue anatomy.
Tip 1 Why is it Important to take a Per-op Scan the Healing Abutment or Temporary Crown
Tooth 30- crown designed with preop scan of soft tissue former shows proper soft tissue support with the ZBLC Crown.
Tooth 19- crown designed without pre-op scan of soft tissue former shows improper support of soft tissue with the ZBLC Crown.
Tip 2 Removing Custom Tissue Former and Temporary Implant Crowns
Utilizing the abutment removal screw to detach soft tissue formers is essential in preventing soft tissue trauma and minimizing the risk of severe bleeding, which can otherwise complicate the impression-taking process. Implant platforms with a Morse taper of 5° to 7° conical connections create a cold weld or tight friction fit, making abutment removal challenging. The use of an abutment removal screw or driver ensures the safe and efficient removal of the abutment, preserving both the integrity of the implant and the surrounding soft tissues.