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Our secret to implant success5 October 2021 Categories: digital dentistry digital lab
When restoring with implants, do you automatically choose a pre-manufactured titanium interface, commonly known as a Ti-base?
Using a Ti-Base system may seem like the obvious and most cost-effective solution when placing all-ceramic or zirconia implant crowns or bridges, however, here at Ambridge Ceramics we like to look at and embrace different solutions. This allows us to offer our customers better, stronger, and generally more suitable restorative solutions in treatments for their patients.
From our own experience, the short, cylindrical design and small locational notch on the body of the Ti-Base is not able to give the same surface area required for bonding or resistance to rotational forces that can be delivered with a laboratory designed CAD-CAM titanium customised base.
A laboratory designed, CAD-CAM manufactured titanium customised base enables us to both customise the emergence profile design to best support the soft tissue. In addition, we are able to design the body to be larger and elliptical in shape (occlusally viewed), making it both more retentive and supportive of the restoration.
In lab tests1, we have found the average bonding area to be almost three times greater on a custom base than on a stock Ti-Base. This offers optimal support and retention, leading to a greater chance of long-term implant success.
Monolithic zirconia is far stronger than a lithium disilicate ceramic (E.max, LiSi, Celtra) in some cases by 2-3 times2. This is a critically important factor when the restoration has a narrow emergence, such as an incisor or narrow bi-cuspid.
In these cases, we finish slightly sub-gingivally in order to hide the ceramic-metal junction, creating a very thin wall section around the titanium base, which could easily fracture under load. We find that zirconia is much less likely to fracture in these situations.
Our standard cementation procedure involves air abrading on both the surface of the titanium customised base and the zirconia internally with 50um aluminium oxide.
This should always be done immediately prior to bonding, followed by the application of a bonding agent containing 10mdp3 on the surface of the Zirconia.
Following this, conventionally cement with purpose-developed Multi-Link Hybrid Abutment Cement by Ivoclar Vivadent.
- Custom Base average cementable surface area = 80mm sq. Vs 27mm sq. average Ti-Base Vs average Custom Base.
- Average pressed Lithium Disilicate ceramic 450mpa Vs average Zirconia 900mpa.
- Functional monomer 10-methacryloyloxy-decyl-dihydrogen-phosphate (10-MDP) was documented to chemically bond to zirconia ceramics
Our basic standard price for the Zirconia monolithic on titanium custom base is £250, all inclusive (if you use our systems and become a client)
Call or email us for more information