The Gingival Cuff Links is a fully customizable/sculptable healing cuff that is to be used to preserve and perfect gingival emergence profile. In addition to being used as a healing cuff, it can be modified to serve as a provisional restoration.
Absolutely. Chairside sculpting/customizing of the Gingival Cuff Links is a distinct feature of the system and is easily done with routine dental materials. Removal of acrylic is easily done with a dental handpiece using the appropriate burs, discs, etc. Addition to the Gingival Cuff Links is simply done by adding flowable composite (no primer necessary) or additional bis-acryl to a dry surface on the Gingival Cuff Links.
Yes. After proper seating, standard dental armamentarium can be used to shape the Gingival Cuff Links as desired. Use of an easy-to-apply barrier, such as medical grade cyanoacrylate (PeriAcryl) or other device/material is highly recommended.
Yes. The Gingival Cuff Links is fully adjustable, so that a prosthesis can be fit over or around it. No heavy or sheer forces should be placed on the Gingival Cuff Links as it could lead to fracture of the acrylic.
Check to see that you have the correct connection placed on the Gingival Cuff Links for the implant.
Verify that the platform of the implant and the connection is clear of debris.
Contouring of bone that would prevent a natural emergence profile should be considered as it will ultimately aid in the seating of the Gingival Cuff Links.
Verify that the implant is properly oriented so that the correct surface of the implant connection is facing buccally to allow the Gingival Cuff Links to be inserted into the implant connection. Most implant systems have a recommended orientation, e.g., an internal hex connection which would recommend that the flat surface of the connection be placed toward the buccal; an internal conical connection would have a series of dots or a line or other marking on the implant placement device indicating which area of the implant should ideally be placed toward the buccal surface. The “T” handle of the Gingival Cuff Links is anatomically in line with manufacture’s recommended orientation as previously noted.
Place the Gingival Cuff Links healing cuff into the implant site to determine if the healing cuff requires sculpting. Removal of acrylic should be done accordingly to allow for proper seating. If additional acrylic needs to be added, it can be done easily with flowable composite (no primer is necessary) or bis-acryl. When properly seated, the healing cuff should seat flush with the implant platform without resistance.
An x-ray should be considered to verify seating of the Gingival Cuff Links healing cuff.
There are several options to consider in decreasing the potential effects of habits in immediately placed implants:
Reducing the height of the Gingival Cuff Links.
Placing an incline bevel on the lingual surface of the healing cuff or provisional crown by removing the lingual cusp.
Placing a splint or other guard over the gingival healing cuff.
Fabrication of the gingival healing cuff or provisional crown from the Gingival Cuff Links can be done at the time of implant placement and then seated after the implant has integrated at the time of uncovering. The Gingival Cuff Links can be autoclaved.
Once the final contour of the Gingival Cuff Links healing cuff or provisional restoration has been established, finishing the periphery can be done to any surface texture desired. Smooth surfaces will allow for limited, to no bleeding, of the gingival tissue when the healing cuff is removed for the restorative phase of treatment. There may be some mild bleeding due to potential tissue attachment to the Gingival Cuff Links which can be controlled using a hemostatic agent. One easy method for obtaining a smooth surface is to paint a thin coat of flowable composite resin on the periphery of the gingival healing cuff or provisional restoration and cure it accordingly.
Generally, regular foods with normal masticatory forces can be applied to a Gingival Cuff Links healing cuff and provisional restoration. Hard foods such as ice, hard nuts or hard candy, as well as sheer forces, should be avoided as they can cause fracture of the acrylic.
Fortunately, this is a rare occurrence as long at the patient avoids hard foods. However, if a fracture of the Gingival Cuff links occurs, freshening of the fractured surfaces and application of flowable composite to bond the surfaces together may be an option.
Yes! Sculpting/customizing of the Gingival Cuff Links is a distinct feature of the system and is easily done with routine dental materials. Removal of acrylic is easily done with a dental handpiece using the appropriate burs, discs, etc. Addition to the Gingival Cuff Links is simply done by adding flowable composite (no primer necessary) or additional bis-acryl to a dry surface on the Gingival Cuff Links.
No two patients have the exact same tooth size, anatomy and position. In addition, an implant in any given tooth site is not placed in the same orientation with the adjacent teeth and bone in every situation. Taking this into consideration, usage of premade alternatives gives you just that, one size usually fits none! If you want ideal soft tissue emergence and a restorative result, you must use a patient and site-specific healing cuff to make it happen. That is the beauty of the Gingival Cuff Links system, sculpting tissue…One time!
Do you want to wait for hours or days to get a custom healing cuff or provisional for your patient? Is that really what your patient would like? In addition, do you or your patient want to have another procedure using more chair time and usually involving another local anesthetic? Use of a lab normally involves all of this unless you have a chairside alternative. Fortunately, the Gingival Cuff Links is that chairside alternative resulting in less appointments, less cost and more patient satisfaction!
Yes! Because the Gingival Cuff Link can be made to fit the exact anatomy of the crestal soft tissue in an immediate extraction site, it can act as a barrier to prevent loss bone grafting material. In addition, medical grade cyanoacrylate (PeriAcryl) can be applied at the junction between the gingival margin and the Gingival Cuff Link to establish a protective barrier. At a second or other stage surgery, grafting can also be done around the Gingival Cuff Links.