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How do I fix temp cylinders that are misaligned, too high, or hard to reach?

Misaligned or divergent cylinders: First check rotation on the angled implants. The best fix is to rotate the implant until the temp cylinder is straight and parallel with the others (remove the MUA and adjust slightly with a hand driver; the implant must be indexed precisely to the hex on the Osteotomy Guide). If you'll pick them up in a tipped position, slightly adjust the prosthetic to remove the contact. Sometimes you can seat the prosthetic on the remaining cylinders and drop the crooked cylinder in from the occlusal hole. Don't over-adjust: keep at least 3 mm from the shaft to the outside of the prosthetic.

Situation What to do
Cylinders touching the sides of the holes Correct rotation as above; if picking up tipped, relieve the prosthetic shaft (keep 3 mm minimum).
Cylinders too high to check occlusion Cut the cylinders down flush with the prosthetic.
Best tool to trim/adjust cylinders Mark with a sharpie first, then trim with a 557 carbide bur (trim in the mouth, or remove and trim). Ideally the bite was already verified at the RAPID, so cylinders can be trimmed after pick-up.
Access hole too deep for the driver Ask the implant rep for a longer driver — ROE's clinical techs bring long lab drivers to surgeries.

 

Additional Resources

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