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.

Custom abutment and crown placed with gold screw tightened to finger pressure.
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.
Gold screw used to attach crown and abutment to implant.
Now the gold screw can be tightened to 20 Newtons per centimeter squared with the torque wrench.
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.

x-ray verification showing implant copings not fully seated
After re-positioning, perfect seating

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

coping xraycoping xray2