Pre-Cemented Implant Crown to Abutment

Screw-Mentable as some call them is a custom abutment pre-cemented at the lab prior to delivery.  As long as the implant placement is parralel to the path of insertion they work great.  If angulation is off a bit, typically they won't seat.  Doesn't take much for a hex to not seat, but most do with little difficulty.  But what if the one-piece will not go to place.  Here are the options:

-Return the case to the lab.  Lab separates the abutment from the crown and returned as a 2-piece, separate abutment and crown.  Abutment is seated, crown is tried in and cemented chairside.

-If original case was scanned, rescan with a scan body.  Once received the new scan is overlayed with the original to detect any inaccuracies.  If found typically the abutment is good even if rotated some.  The original design is then readapted to the new position and the crown is remilled.

Other Options

-Send to lab to separate.  Lab returns abutment.  Place abutment, retract tissue, scan as a new case. Leave abutment in place, temp if needed. (If abutment margin is under tissue a lot, more than 1mm, not a good option)

-Send to lab to separate.  Lab returns abutment.  Place abutment, retract tissue, take a traditional impression. Leave abutment in place, temp if needed.  (If abutment margin is under tissue a lot, more than 1mm, not a good option)

-Send to lab to separate. Lab returns abutment. Place abutment using it as a traditional impression post, take traditional impression, send abutment and impression to be poured up with a traditional analog.  

-Place a traditional impression post, take a traditional impression.