In this video, Alex discusses the restorative options for the original IMZ non-hexed implant.
00:00 Introduction
Restoring older implants can be difficult, especially when most of the restorative components have been discontinued. This is definitely true for the original IMZ implants and in this video, I'm going to go over the restorative options you have for that system.
The original IMZ is a non-hexed implant, meaning there aren't any anti-rotational elements built in to the interface. This is not to be confused with the IMZ hex head implant that was released later.
00:36 How to Identify
You can identify the original IMZ radiographically by a few notable features.
- First, there are no external threads on the implant body
- Second, you'll see oblong holes near the apex of the implant
- And finally, the internal diameter is fairly big because the IMZ screws are larger than most other implants
01:06 IME and UMA
Many, if not most IMZ implants were restored using an intermediary abutment, such as the IME and the UMA. These abutments are a very similar style to the Multi-Unit abutment which is commonly used today. Unfortunately, we can no longer get compatible parts for these abutments.
With the limited parts available for this system, I'm going to show you the restorative options you have for single units, splinted units, and for removable prostheses.
02:29 Options for Cement Retained
For cement retained, there's really only one abutment that will work for single units and it's a stock titanium sold by Titan Implants. The abutments are cylindrical with one flat side and a uniform margin height.
These abutments have integrated screw threads, instead of having a separate screw. So, when you place these in the implant, you'll be rotating the entire abutment to screw it in to place. They also don't have thread timing, which means that every time the abutment is rotated in to place, that flat side will be in a different position.
To restore with these, you'll need to seat the abutment and evaluate height. If additional clearance is needed, you'll need to remove the abutment, prep it, and return it to the implant. Once you've determined that adequate space exists, torque the abutment in to place and take an impression similar to a crown prep.
03:46 Options for Screw Retained
For screw retained, Titan implants does sell a castable post with a separate screw, but these can only be used for PFM or FCG.
In order to use the castable post, you would need to take an implant level impression so that a model can be poured with an implant replica.
04:43 Splinted Restorations
For splinted restorations, the restorative options are the same as for single units. The big advantage of splinting these is that the non-hexed interface doesn't create the same problem as it does for single units. That's because once you splint two implant abutments together, they can no longer freely rotate on the implant.
The big disadvantage to doing a cement retained bridge on these is that you're going to have to make sure the abutments are parallel. This means you'll have to torque the abutments in to place and then prep them in the mouth. If you are splinting one IMZ with a newer implant, this may not be an issue. In that situation, you can torque the IMZ post in to place and take the impression over it while using an impression coping for the other implant. The lab will then pour up a model that has an analog for the other implant, while the IMZ abutment will be represented in stone. The lab can then scan in the case and design the abutment for the other implant to be parallel with the IMZ abutment.
The castable abutments I mentioned earlier will also work for making screw retained bridges, and in fact they are better suited to splinting than for single units.
06:11 Removable Prostheses
Finally, removable prostheses are the easiest way to go with these implants. Locator abutments are available for the original IMZ and it's what we would recommend using.
If you'd prefer to use a ball abutment instead of Locator, you can get those from Titan as well. But, they do require more vertical space than Locator and they can only accommodate a total divergence of 10 degrees between implants as opposed to the 40 degrees with Locator.
Alex Rugh, CDT
O'Brien Dental Lab
www.obriendentallab.com
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