Inside Dental Technology
July 2016
Volume 7, Issue 7

The Solution to the Ti Base Confusion

A case study on the ATLANTIS CustomBase solution

By Jeremy Pearson, CDT

The FDA 510(k) process for Ti base interfaces for implants gets more and more confusing. Many have questions relating to designing and milling abutments and full crowns. Do I need FDA approval? Can I mill in-house? Is there a warranty to protect me?

A solution to these questions is the incorporation of ATLANTIS CustomBase. ATLANTIS solutions have FDA 510(k) approval and a comprehensive warranty (subject to full terms and conditions of the abutments’ warranty by DENTSPLY Implants). This solution offers the convenience of using your laboratory scanner or intraoral scanner. Whatever design you mill over the abutment can be milled in the laboratory using the ATLANTIS Core File.

These benefits allow you to have more control than if you use a stock Ti base from within any implant system. The following case shows the benefits of using the ATLANTIS CustomBase solution.

Three units were fabricated on two screw-retained ATLANTIS CustomBase abutments: a single unit and a 2-unit cantilever bridge. The CustomBase option solved our issues with margin placement, abutment height, and strength.

The implant was chosen and scanned into a CAD/CAM software program using an ATLANTIS FLO (Feature Locating Object; also known as a scan body). The order was placed in ATLANTIS WebOrder for the ATLANTIS CustomBase abutment and the corresponding ATLANTIS Core Files. The implant fixture was 1.0 mm below the tissue. A pre-fabricated zirconia abutment with a titanium base would place the margin 1.5 mm above the tissue, and therefore metal would show at the gingiva. The CustomBase solution gave us the option to lower the margin to an appropriate depth.

The images of the proposed design of the CustomBase and crown were viewed in the editor module of ATLANTIS WebOrder. The placement of the abutment margins and length of the core walls of the abutment were evaluated. We were able to design the margins and lengthen the abutment walls, allowing for the emergence profile of the restoration to have a more natural appearance and better strength. While the CustomBase abutments were being fabricated, the ATLANTIS Core File was downloaded into a CAD/CAM system, allowing for fabrication of esthetic zirconia restorations.

The restorations were then milled in preparation for the porcelain to be added to the facial and stain to the occlusion. The final step was to cement (RelyX™ Unicem, 3M, 3m.com) the restorations to the ATLANTIS CustomBase. The case was then shipped. This process helped to achieve natural esthetics that pleased both the patient and the dentist.

Disclaimer: The statements and opinions contained in the preceding material are and not of the editors, publisher, or the Editorial Board of Inside Dental Technology.

Key Takeaways

• FDA 510(k) clearance and comprehensive ATLANTIS warranty
• Solution for all major implant systems with or without Ti bases
• Control of the margin placement and abutment height
• Walls of the abutment are designed to be parallel to the adjacent teeth, while keeping the screw access hole available
• Crowns can be designed using ATLANTIS Core File within a few hours of abutment design approval

About the Author

Jeremy Pearson, CDT
Implant Advisor and Kois Recognized Specialist
Summit Dental Lab
Waco, TX

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