Importance of taking a radiograph to verify accurate interface of the custom abutment to implant.

In this case report Dr. Gentry demonstrates the importance of taking a radiograph when seating the custom abutment and crown before final torquing of the gold implant interface connecting screw.

unnamed-1 — Custom abutment and crown placed with gold screw tightened to finger pressure.

unnamed-9 — Upper radiograph shows improper interface-note the gap present at the interface. Lower radiograph shows perfect fit, taken after adjusting the contact and re-positioning the crown/abutment on the implant.

unnamed-10 — Gold screw used to attach crown and abutment to implant.

unnamed-2 — Now the gold screw can be tightened to 20 Newtons per centimeter squared with the torque wrench.

unnamed-3 — Screw hole filled in with composite filling material.

Here’s an example from a case I was doing with a dental student involving the 2 upper front teeth. In the first x-ray the impression copings were not fully seated. I re-positioned the copings and another x-ray was taken to confirm proper alignment. You cannot tell without an x-ray since this is below the gum-line.

implantseating1 — x-ray verification showing implant copings not fully seated

implantseating2 — After re-positioning, perfect seating

Here’s an example of another implant check x-ray to verify proper seating.