Intraoral trimming of titanium abutment for single piece implants-Current scenario!

Intraoral trimming of titanium abutments!   

   There has been some controversies among the conventional dental implantologists regarding the intraoral trimming of titanium abutments.

The purpose of this post is to throw some light upon this subject..

The common misconceptions about this subject among dental fraternity are..

    1.Titanium should not be trimmed intramurally

    2.Heat generation during trimming will affect the implant and the surrounding bone

    3.Vibration of trimming will affect the stability of the implant

Do's and don'ts during intraoral trimming of implant abutment  ..

    1.Trim the abutment under copious irrigation.Irrigation greatly reduces the temperature rise during abutment trimming.

    2.Don't use diamond bur..It generates more heat and it takes more time to trim the abutment

    3.Use cross cut carbide fissure bur..they are efficient and make your job much easier

    4.Dont use old burs.Always use new burs..

    5.If possible cold irrigation

    6.Whatever trimming is needed,finish it on the day of implant placement itself.Dont do on the next few days.

 It is interesting to note that the popular brand Nobel also advises intraoral trimming of titanium abutment!!..

I have attached the page below..         

106 NobelEstheticsTM Manual // Appendices

Frequently asked questions.

Question
What happens if a screw head breaks and I can no longer take it out with the screwdriver?
Can I prepare a titanium abutment intra-orally?
Why is the titanium section of the NobelProcera Abut- ment Zirconia with an internal tri-channel connection removable? How is it fixed?
How should I adjust a NobelProcera Abutment Zirconia/ Procera Esthetic Abutment?

Answer
If all attempts to remove the abutment screw have failed, retrieval instruments or a screw removal kit can be used to retrieve the abutment screw and, if necessary, repair the in- ternal threading of the implant. Detailed instructions on how to use the retrieval instruments/screw removal kit are included in the product packaging.

Yes. Adjustments can be made intra-orally. Use cross-cut car- bide burs and copious water irrigation during the preparation.

When the ceramic abutment with an internal connection is used for direct application of veneering material, the titani- um part should be removed before firing. Once the titanium part is reinserted into the abutment and the abutment screw is tightened to the recommended torque of 35 Ncm using the Manual Torque Wrench Prosthetic, this titanium part is fixed to the abutment.
Use new, sharp diamond instruments to make adjustments to NobelProcera Abutment Zirconia or Procera Esthetic Abutment – excessive heat can cause micro-cracks in zirconia. Make sure you use copious irrigation and light pressure. Note that only minor modifications of the height and/or the margins are recommended (see pages 28 and 33). 
To see the entire pdf filehttp://www.google.co.in/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&ved=0CCsQFjAA&url=http%3A%2F%2Fwww.nobelbiocare.com%2Fen%2Fproducts-solutions%2Fnobelguide-concept%2FdHlwZT1PUkcmcmVjb3JkSWQ9UFJPRE1UUkxfMDAwNDQyNF8xJmxhbmd1YWdlPWVu.gmt&ei=xGwMUqzHEsqjrQeiyIDgAg&usg=AFQjCNER8zqtDIzD9IQWqVGy8eLy2w0ZNg&sig2=OhHDh9echg-prORHyNSMWA&bvm=bv.50768961,d.bmk

Kindly take time read this RESEARCH article about trimming of ZIMMER one piece implants..
 http://www.zimmerdental.com/pdf/lib_artHeatGeneration2008Joo.pdf