Restorative Manual CATRM
Restorative Manual CATRM
Restorative Manual
Icon Key:
Certain
Internal Connection
Implant System:
External Hex Connection
Implant System:
Certain Internal and External Hex
Connection Implant Systems:
How To Use The Icon Key:
The icons represent the connection types of the
BIOMET 3i Implant and Abutment Systems for both
internal and external connection types represented in
this manual. In the fully illustrated protocols, each icon
is present next to each step. When a solid blue icon
and a light blue icon are present together, the solid blue
indicates which system is illustrated. When both icons are
solid blue, then both systems are illustrated together.
Table Of Contents
Table Of Contents
Introduction ...............................................................................................................................................1
Implant & Abutment System Connections
Certain
Internal Connection .................................................................................................................. 2
External Connection ............................................................................................................................... 3
Certain QuickSeat
Activator Tool........................................................................................................4
Certain Hexed & Non-Hexed Pick-Up Impression Coping Draw Angles ........................................5
Certain UCLA Abutment .........................................................................................................................6
Certain Non-Hexed Abutments .............................................................................................................7
Implant & Abutment Level Impressions
How To Choose A Coping ..................................................................................................................... 8
Pick-Up Impression Copings ................................................................................................................... 9
Twist Lock
Internal Connection
The internal connection aspect of the implant and abutment are designed
for ease of use and simplicity.
QuickSeat
(Emergence Prole) diameters and a straight diameter to match the
corresponding Healing Abutment. The Impression Copings also click
when properly seated. These copings have a different nger design that
engages 2mm internally into the implant, as compared to the abutments
design that engages 4mm deep into the implant. This shorter engagement
into the implant is important because it allows off-axis draw for implant
impressions that are divergent.
Color-Coding: Certain Implants and all interfacing components are
color-coded by restorative platform diameter for easy identication
and selection.
(purple)
3.4mm
(blue)
4.1mm
(yellow)
5mm
(green)
6mm
Materials:
3i T3
and
Conical Abutments.
The 12-point double hex, which is machined in the 15 Pre-Angled
GingiHue Abutment, provides rotational positioning in 30 increments
on the implant hex.
Precise Abutment Placement: The ASYST Abutment Placement Tool
provides ngertip control for fast and easy abutment delivery. The
patented packaging design makes abutment placement easier because the
abutment is delivered sterile from the package directly to the implant site.
The abutment and abutment screw are packaged inside the plastic ASYST
seating device. The plastic seating device facilitates precise placement of
the abutment on the implant, thus reducing chair time. The ASYST Tool
is packaged with Low Prole, Standard and Conical Abutments.
Impression Copings: Pick-Up and Twist Lock Transfer Copings are
both available in the external connection design in three EP
(Emergence
Prole) diameters and a straight diameter to match the corresponding
healing abutment. The patented Twist Lock design provides a more
accurate transfer of the implant connection as compared to other
transfer (closed tray) techniques. This unique Twist Lock feature provides
a series of undercuts to guide the coping into the impression, giving
stability to the impression coping/analog prior to pouring the impression.
As a result, the copings lock into orientation grooves upon clockwise
rotation, thereby allowing for a tactile sensation of resistance that ensures
an accurate hex transfer.
Materials:
OSSEOTITE
QuickSeat
Activator Tool
Figure 3
The QuickSeat Activator Tool is used to verify that the
ngers on impression copings and abutments are in the
proper position for proper retention when placed into
the implant (Figure 1).
The QuickSeat Activator Tool is marked on both ends
to indicate impression coping activation or abutment
activation.
To activate the QuickSeat Fingers, locate the proper
end for the component.
Impression Copings: Insert the impression coping
onto the pin, ngers rst and slide inward until the
ngers meet the tool (Figure 2).
Abutments: Insert the abutment onto the pin,
ngers rst and slide inward until the platform meets
the tool (Figure 3).
Remove the component from the pin and insert it into
the implant.
In addition, there is an area indicated on the tool
for deactivating the ngers on a Hexed UCLA
Abutment (Figure 4). This may be necessary during
waxing, nishing or porcelain application when
laboratory technicians prefer to insert and remove the
abutment from the analog without nger retention.
After the custom abutment or crown is completed, the
UCLA ngers must be reactivated (Figure 5).
UCLA Abutment QuickSeat Activation
GingiHue
and
Conical Abutment
Fingers
Impression Coping
Fingers
Figure 1
Impression Coping QuickSeat Activation
Figure 2
Figure 5
Abutment QuickSeat Activation
UCLA Abutment QuickSeat Deactivation
Figure 4
5
Certain
UCLA Abutment
The Certain Internal Connection line of restorative components
includes UCLA Abutments. This design provides greater predictability
and more exibility for laboratory technicians when waxing and
casting implant level restorations relative to conventional prefabricated
abutments.
Cylinder Retention Design
The cylinder retention design incorporates machined vertical
grooves that reduce the potential for miscasts due to the smoother
alloy ow onto the gold alloy cylinder during casting. The vertical
grooves provide mechanical retention for the alloy by stopping on
the horizontal retention instead of owing to the margin (Figure 1).
Chamfer Margin
The chamfer margin design provides a smooth transition from
the gold alloy cylinder to the cast alloy at the junction of the two
metals. It also aids in preventing the alloy from owing onto the
implant restorative platform of the gold alloy cylinder during casting
(Figure 1).
Collar Height
The collar height is 0.25mm to provide greater exibility when
fabricating restorations for implants with shallow tissue depths. This
allows the restoration to emerge from the implant platform more
quickly and to add porcelain closer to the implant platform on
screw-retained restorations (Figure 2).
Collar Adjustment After Casting
The 0.25mm collar height may cause an undercut laterally around
the implant platform. The undercut should be removed after
casting by tapering the collar back (Figure 3).
Waxing Sleeve
Chamfer Margin
Cylinder
Retention Design
Collar Height
4mm
0.25mm
Figure 1
Figure 3
Screw-Retained
Crown
Crown Coping
Certain UCLA
Abutment
Cement-Retained
Crown
Custom Abutment
Certain UCLA
Abutment
4.1mm
5mm
5.5mm 6.5mm
6mm
4.1mm 5mm 6mm
Figure 2
4.5mm
7
Certain
Non-Hexed Abutments
Certain Non-hexed Abutments are designed to provide
exibility for laboratory technicians when fabricating splinted
multiple-unit, screw-retained provisional restorations, as well
as bridge frameworks and bars for implant level restorations.
Internal Engagement
Non-hexed abutments have a 1mm internal engagement
feature to allow a greater degree of draw from multiple
divergent implants than other internal connection implant
systems (Figure 1).
Large Diameter Abutment Screw
Non-hexed abutments are retained into the implants with
a unique Large Diameter Gold-Tite
or Titanium Abutment
Screw. The larger diameter screws provide lateral stability
to the restoration. It goes into the full depth of the internal
connection, replacing the 4mm length of the hexed
abutments connection (Figure 1).
Maximum Draw Of Non-Hexed Abutments
Non-hexed abutments have a maximum draw angle of 40
between implants (Figure 2).
Gold Alloy Cylinder Formulation
The formulation specics for the gold alloy cylinder
material used with the UCLA Abutments is indicated on
the chart to the right. The formulation should be taken into
consideration during burnout and casting procedures.
GOLD ALLOY CYLINDER FORMULATION
Melting Range 1400-1490 C (2550-2710 F)
Solidus 1400 C
Liquidus 1490 C
CTE 13.5 x 10
-6
K at 500 C
An alloy with a CTE of 14.5 x 10
-6
K at 500 C is recommended.
Large Diameter
Gold-Tite Abutment Screw
Internal Engagement
Figure 1
Certain Non-Hexed UCLA Abutment
4mm
1mm
Figure 2
40 Divergence Between Splinted Implants
8
Implant & Abutment Level Impressions
How To Choose A Coping
Choices
Pick-Up Impression Coping (open tray)
The Pick-Up Impression Coping transfers the position of an implant hex to a laboratory cast. The coping is picked up
inside the impression when the impression is removed from the mouth. An open impression tray is used with the
Pick-Up Impression Coping.
Note
Pick-Up Impression Copings may be difcult to use in limited, interarch distance spaces.
Pick-Up Impression Copings are ideal for use when an impression is made of multiple divergent implants
(see page 5).
Twist Lock
Internal Connection
System Is Illustrated)
(purple)
3.4mm
(blue)
4.1mm
(yellow)
5mm
(green)
6mm
10
Implant & Abutment Level Impressions
Pick-Up Impression Copings (Contd)
5. Medium or heavy body impression material is recommended
for the impression material in the impression tray. Use light-body
or injection consistency impression material and syringe impression
material around the entire Pick-Up Impression Coping.
6. Load the impression tray and seat it in the mouth. Wipe
impression material off the top of the screw so that the screw hex
is visible and free of impression material before it sets. Allow the
impression material to set per the manufacturers instructions.
7. After the impression material has set, unscrew and remove
the Pick-Up Impression Coping Screw using a .048 Large Hex
Driver (PHD02N or PHD03N). Remove the impression from
the mouth.
8. Verify that the impression material has completely adapted
around the coping and that there is no impression material on the
impression copings restorative platform.
(Certain
Internal Connection
System Is Illustrated)
11
Implant & Abutment Level Impressions
Pick-Up Impression Copings (Contd)
9. Immediately replace the healing abutment on the implant using
a .048 Large Hex Driver Tip (RASH3N or RASH8N) with a torque
device and torque to 20Ncm.
10. Laboratory
Place the proper diameter Implant Lab Analog onto the
impression coping, engaging the hex. Hold the analog in place while
tightening the screw with a .048 Large Hex Driver. Verify that the
impression coping is completely seated on the analog. If the clinician
is sending the impression to a commercial laboratory to pour the
impression, do not attach the analog.
11. Syringe soft-tissue material around the coping and analog
interface. Pour the cast in die stone. Articulate with the opposing cast.
(Certain
Internal Connection
System Is Illustrated)
12
Implant & Abutment Level Impressions
Twist Lock Transfer Impression Copings
Restorative Dentist
1. Select the proper Twist Lock Impression Coping by matching
the EP
Diameter of the healing abutment and the color of the
implant platform. To determine platform diameter, see below.
Remove the healing abutment from the implant using a .048 Large
Hex Driver (PHD02N or PHD03N). To help prevent accidental
swallowing, thread oss through the spinner on the driver.
2. Activate the ngers using the QuickSeat
Diameter
from the healing abutment for selecting the proper size abutment.
The implant platform diameter is also identied by the color code
anodized on the implants and components (see below).
2. Select the proper abutment collar height by measuring the
height of the healing abutment above the tissue, NOT including the
domedd portion. Subtract the measurement from the total height of
the healing abutment.
3. Using a .048 Large Hex Driver (PHD02N or PHD03N),
evaluate angulation by inserting the driver into the healing abutment
hex. To help prevent accidental swallowing, thread oss through
the spinner on the driver. If the angle appears to be more than 10,
use the Prosthetic Angle Guide Kit to determine the approximate
angulation of the implant. The Prosthetic Angle Guide Kit consists of
15, 25 and 35 degree pins in 2, 4 and 6mm collar heights.
To use angled guides, healing abutments must be removed from
the implants.
4. Place the pins into the implant to select the proper angled
abutment. To help prevent accidental swallowing, thread oss
through the spinner on the driver. The correct angle will have the
guide pin in line with the central fossa of the adjacent posterior teeth
or the incisal line angle of the adjacent anterior teeth.
EP (Emergence Prole)
Restorative Platform
Height
(purple)
3.4mm
(blue)
4.1mm
(yellow)
5mm
(green)
6mm
16
Restorative Products Flow Chart
Cement-Retained Restorations
Screw-Retained Restorations
Is The Implant Angled?
(Greater than 15 Divergence)
Interarch Space
15 Pre-Angled GingiHue
UCLA
BellaTek
Yes No
Is The Implant Angled?
(Greater than 15 Divergence)
Yes No
Less than 7mm
UCLA
BellaTek
7mm or more
Less than 2mm
UCLA
BellaTek
Provide
2mm or more
GingiHue
UCLA
ZiReal
BellaTek
Provide
Less than 2mm
UCLA
BellaTek
2mm or more
15 Pre-Angled GingiHue
UCLA
BellaTek
Less than 7mm
UCLA
BellaTek
7mm or more
15 Pre-Angled GingiHue
UCLA
BellaTek
Is the implant centered in the tooth site?
If the answer is no, UCLA is the best option.
UCLA
Low Prole
Conical
IOL
UCLA ZiReal
Provide
Abutment Selection
1. Select the proper abutment collar height by measuring the
height of the healing abutment above the tissue on the buccal surface,
not including the domed portion. Subtract this measurement from
the total height of the healing abutment, then subtract an additional
1mm. The resulting abutment collar height will place the crown
margin 1mm subgingival on the buccal surface. However, the margin
may be signicantly deeper in the interproximal areas, depending on
the degree of gingival scallop. Next, select the proper post height that
will allow approximately 2mm of interarch distance between the top
of the post and the opposing occlusion. Finally, match the color of the
implant platform to determine the platform diameter.
2. Remove the healing abutment using a .048 Large Hex Driver
(PHD02N or PHD03N). To help prevent accidental swallowing,
thread oss through the spinner on the driver.
3. Activate the ngers on the Provide Abutment using the
QuickSeat
Abutment Placement
1. Place the Provide Abutment into the implant. Line up the
hexes and place the at side of the post to the buccal surface.
Press rmly until hearing and feeling the audible and tactile click.
2. Thread the Certain
Gold-Tite
Implant System.
In many cases, with proper abutment selection and ideal angulation, preparation of the abutment will not be
necessary. The following is the restorative procedure for a non-prepared Provide Abutment with a minimal
gingival scallop.
See pages 18 and 19 for Provide Abutment selection and placement.
21
Cement-Retained
Provide
Implant System.
Some circumstances will require the clinician to prepare the Provide Abutment. The following is the restorative
procedure for preparing a Provide Abutment and the associated impression and laboratory procedures.
See pages 18 and 19 for Provide Abutment selection and placement.
25
Cement-Retained
Provide
Provisional Post
Indirect Technique
Material:
PEEK; Titanium Alloy Connection
PreFormance Post Indications:
Single and Multiple-Unit Cement-Retained Provisional Restorations
Minimum Interarch Space of 6mm
Maximum Angulation of 15 Degrees
Intraoral Use Limited to 180 Days
Immediate Non-Occlusal Loading of Single-Unit Provisional Restorations
Multiple-Unit Restorations
Guided Soft-Tissue Healing of Single and Multiple-Unit Restorations of Integrated Implants
Restorative Dentist
1. Follow the steps for Implant Level Impressions on pages 9-11
for the Pick-Up Technique and pages 12-14 for the Twist Lock
Transfer Technique.
2. Laboratory
Select the PreFormance Post with the desired EP
Emergence
Prole diameter and collar height. Measure the interproximal tissue
heights and select a collar height that can be prepared to follow the
gingival contour. Match the color of the implant platform.
Place the PreFormance Post into the implant analog, line up
the hex and press rmly until hearing and feeling the audible and
tactile click.
Or
Place the proper PreFormance Post onto the implant analog,
engaging the hex.
3. Thread a Hexed Titanium Screw (IUNIHT or UNIHT) into
the analog until ngertight using a .048 Large Hex Driver (PHD02N
or PHD03N). Mark the PreFormance Post with a pencil in areas
requiring preparation.
4. Prepare the PreFormance Post in areas marked to the desired
depth using a carbide bur. Rene with a coarse diamond bur. Prepare
margins according to xed prosthodontic principles, following the
gingival contours. The post can be prepared on the cast or may
be removed and placed on a laboratory abutment holder for
preparation. Maintain three walls of the abutment and at least .5mm
of wall thickness during preparation.
28
Cement-Retained
PreFormance
Provisional Post
Indirect Technique (Contd)
5. Block out the screw access opening with wax. Fabricate the
provisional crown on the prepared PreFormance Post using the
provisional material of choice.
Restorative Dentist
6. Remove the healing abutment from the implant using a
.048 Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the driver.
Activate the ngers using the QuickSeat
Provisional Post
Direct Technique
Clinician
1. Select the PreFormance Post with the desired EP
Emergence
Prole diameter and collar height. Measure the interproximal tissue
heights and select a collar height that can be prepared to follow the
gingival contour. Match the color of the implant platform.
Activate the ngers using the QuickSeat
Provisional Post
Indirect Technique
Restorative Dentist
1. Follow the steps for Implant Level Impressions on pages 9-11
for the Pick-Up Technique and pages 12-14 for the Twist Lock
Transfer Technique.
Laboratory
2. Select the PreFormance Post with the desired EP
Emergence
Prole diameter and collar height. Measure the interproximal tissue
heights and select a collar height that can be prepared to follow the
gingival contour. Match the color of the implant platform. The post
may be rotated in 30 increments to ideally position it to correct the
implants angulation.
Place the Pre-Angled PreFormance Post onto the implant
analog, line up the hex in the 12-point double hex and press rmly
until hearing and feeling the audible and tactile click.
Or
Place the proper Pre-Angled PreFormance Post onto the
implant analog, engaging the hex.
3. Thread a Hexed Titanium Screw (IUNIHT or UNIHT) into
the analog until ngertight using a .048 Large Hex Driver (PHD02N
or PHD03N). Mark the PreFormance Post with a pencil in areas
requiring preparation.
4. Prepare the Pre-Angled PreFormance Post using a carbide
bur. Rene with a coarse diamond bur. Prepare margins to
1mm subgingival. The post can be prepared on the cast or may
be removed and placed on a laboratory abutment holder for
preparation. Maintain three walls of the abutment and at least .5mm
of wall thickness during preparation.
31
Cement-Retained
15 Pre-Angled PreFormance
Provisional Post
Indirect Technique (Contd)
5. Fabricate the provisional crown on the prepared PreFormance
Post using the provisional material of choice.
Restorative Dentist
6. Remove the healing abutment from the implant using a
.048 Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the driver.
Activate the ngers using the QuickSeat
Provisional Post
Direct Technique
Clinician
1. Select the PreFormance Post with the desired EP
Emergence Prole
diameter and collar height. Measure the interproximal tissue heights and
select a collar height that can be prepared to follow the gingival contour.
Match the color of the implant platform.
Activate the ngers using the QuickSeat
Transfer Technique.
Laboratory
2. Set a denture tooth in wax on the cast where the single tooth
is missing.
Make a vacuum formed template over the denture tooth and
adjacent teeth on the cast. Remove the template, denture tooth and
wax from the cast.
3. Select the proper diameter Hexed PreFormance Temporary
Cylinder by matching the color of the implant platform. Place it into
the implant analog, line up the hex and press rmly until hearing and
feeling the audible and tactile click (see page 4).
Or
Place the proper diameter Hexed PreFormance Temporary
Cylinder onto the implant analog and engage the hex.
Thread a Waxing Screw (IWSU30 OR WSU30) into the
analog until ngertight using a .048 Large Hex Driver (PHD02N or
PHD03N).
4. Reduce or adjust the cylinder as necessary. Block out any
undercuts apical to the contact points of the adjacent teeth.
Material:
PEEK; titanium alloy connection
Indications:
Screw-Retained Single-Unit Provisional Restorations
Minimum Interarch Space of 4mm
Minimum Tissue Height of 2mm
34
Screw-Retained
PreFormance
Transfer Technique.
Laboratory
2. Set denture teeth on the cast where the multiple-unit xed
provisional restoration will be fabricated.
3. Make a vacuum formed template over the denture teeth and
adjacent teeth. Remove the template, denture teeth and wax from
the cast.
4. Select and place the proper diameter Non-Hexed
PreFormance Temporary Cylinders onto the implant analogs.
Thread Waxing Screws (IWSU30 OR WSU30) into the analogs until
ngertight using a .048 Large Hex Driver (PHD02N or PHD03N).
Indications:
Screw-Retained Multiple-Unit Provisional Restorations
Minimum Interarch Space of 4mm
Minimum Tissue Height of 2mm
Maximum Divergence of 40 Between Implants
Material:
PEEK; titanium alloy connection
36
Screw-Retained
PreFormance
Transfer Technique.
Laboratory
2. Set a denture tooth in wax on the cast where the single tooth
is missing.
3. Make a vacuum formed template over the denture tooth and
adjacent teeth on the cast. Remove the template, denture tooth and
wax from the cast.
4. Select the proper diameter Hexed Titanium Temporary
Cylinder by matching the color of the implant platform. Place it into
the implant analog, line up the hex and press rmly until hearing and
feeling the audible and tactile click (see page 4).
Or
Place the proper diameter Hexed Titanium Temporary
Cylinder onto the analog and engage the hex.
Thread a Waxing Screw (IWSU30 OR WSU30) into the
analog until ngertight using a .048 Large Hex Driver (PHD02N
or PHD03N).
Material:
Titanium Alloy
Indications:
Screw-Retained Single-Unit Provisional Restorations
Minimum Interarch Space of 4mm
Minimum Tissue Height of 2mm
38
Screw-Retained
Titanium Provisional Cylinder - Single-Unit
Indirect Technique (Contd)
5. Reduce or adjust the cylinder as necessary. Block out any
undercuts apical to the contact points of the adjacent teeth.
6. Cut a hole in the template to accommodate the waxing screw.
Add acrylic resin to the cylinder and template and place the template
on the cast to form the single-unit provisional crown. Allow the
acrylic resin to set per the manufacturers instructions. Remove the
waxing screw and template from the cast. Remove the provisional
crown from the template. Place a matching laboratory analog onto
the restorative platform. Fill any voids around the subgingival area.
Contour and polish the crown. Place the crown back onto the cast
and thread a Hexed Titanium Screw (IUNIHT or UNIHT) into the
analog until ngertight. Adjust the occlusion as necessary.
Restorative Dentist
7. Remove the healing abutment from the implant using a
.048 Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the driver.
Activate the ngers using the QuickSeat
Transfer Technique.
Laboratory
2. Set denture teeth on the cast where the multiple-unit xed
provisional restoration will be fabricated.
3. Make a vacuum formed template over the denture teeth and
adjacent teeth. Remove the template, denture teeth and wax from
the cast.
4. Select and place the proper diameter Non-Hexed Titanium
Temporary Cylinders onto the implant analogs. Thread the Waxing
Screws (WSK10 or WSK15) into the analogs until ngertight using a
.048 Large Hex Driver (PHD02N or PHD03N).
Material:
Titanium Alloy
Indications:
Screw-Retained Multiple-Unit Provisional Restorations
Minimum Interarch Space of 4mm
Minimum Tissue Height of 2mm
Maximum Divergence of 40 Between Implants
40
Screw-Retained
Titanium Provisional Cylinder - Multiple-Unit
Indirect Technique (Contd)
5. Reduce or adjust the cylinders as necessary The cylinders may
be connected with ortho wire or a framework may be waxed and
cast to support a pontic. Block out any undercuts apical to the contact
points of the adjacent teeth.
6. Cut holes in the template for the waxing screws to come
through. Add acrylic resin to the cylinders and inside the template to
form the provisional prosthesis. Place the template on the cast. Allow
the acrylic resin to set per the manufacturers instructions. Remove
the waxing screws and the template from the cast. Remove the
provisional prosthesis from the template. Place matching laboratory
analogs onto the restorative platforms. Fill in any voids around the
subgingival areas. Contour and polish the prosthesis. Place the
prosthesis back on the cast and thread Hexed Titanium Screws
(IUNIHT or UNIHT) into the analogs until ngertight. Adjust the
occlusion as necessary.
Restorative Dentist
7. Remove the healing abutments from the implants using a
.048 Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the driver.
Place the multiple-unit provisional restoration onto the implants.
Thread the Hexed Titanium Screws (IUNIHT or UNIHT) into the
implants until ngertight using a .048 Large Hex Driver (PHD02N
or PHD03N).
Radiograph the interfaces to verify a passive t. Check the
interproximal and occlusal contacts. Torque the screws to 20Ncm
using a .048 Large Hex Driver Tip (RASH3N or RASH8N) and
a torque device. Place protective material into the screw access
openings. Seal the access openings with temporary lling material and
composite resin. Make any necessary occlusal adjustments.
41
Cement-Retained
GingiHue
Post
Indirect Technique
Restorative Dentist
1. Follow the steps for Implant Level Impressions on pages 9-11
for the Pick-Up Technique and pages 12-14 for the Twist Lock
Transfer Technique.
Laboratory
2. Select the proper GingiHue Post by matching the EP
Diameter of the healing abutment and matching the color of the
implant platform.
Place the GingiHue Post into the implant analog, line up the hex
and press rmly until hearing and feeling the audible and tactile click.
Or
Place the proper GingiHue Post onto the implant analog,
engaging the hex.
Thread a Try-in Screw (IUNITS or UNITS) into the analog until
ngertight using a .048 Large Hex Driver (PHD02N or PHD03N).
Mark the GingiHue Post with a pencil in areas requiring preparation.
3. Prepare the GingiHue Post in areas marked using a high-speed
handpiece and an aggressive carbide bur. Prepare margins 1mm
subgingival following the gingival contours. The post can be prepared
on the cast or may be removed and placed on a laboratory abutment
holder for preparation.
4. Wax the single-unit crown coping on the prepared abutment.
Invest, burnout and cast the coping in a low, medium or high noble
alloy. Opaque, build porcelain stain and glaze the crown.
Material:
Titanium Alloy (Certain
Straight Posts
and all 15 Pre-Angled Posts)
Commercially Pure Titanium (External
Hex Straight Posts)
Indications:
Single and Multiple-Unit Porcelain-Fused-to-Metal Restorations
Areas of Thin Labial Tissue Where Gingival Discoloration is Possible
Maximum Angulation Correction of 15
Minimum Interarch Space of 6mm
Straight Pre-Angled
42
Cement-Retained
GingiHue
Post
Indirect Technique (Contd)
Restorative Dentist
5. Remove the healing abutment from the implant using a
.048 Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the driver.
Activate the ngers using the QuickSeat
Gold-Tite
Post
Direct Technique
Restorative Dentist
1. Select the proper GingiHue Post by matching the EP
Diameter of the healing abutment and matching the color of the
implant platform. Remove the healing abutment using a .048 Large
Hex Driver (PHD02N or PHD03N). To help prevent accidental
swallowing, thread oss through the spinner on the driver.
Activate the ngers using the QuickSeat
Gold-Tite
Post
Direct Technique (Contd)
4. Place protective material into the screw access opening.
Seal the access opening with temporary lling material. Place a
retraction cord subgingivally to retract the gingiva from the margin
prepared on the GingiHue Post. Syringe regular or injection viscosity
impression material around the abutment. Load the impression tray
with medium or heavy viscosity impression material and seat it in the
mouth. Allow the impression material to set per the manufacturers
instructions.
NOTE: Placing a retraction cord around implant abutments is
typically more difcult than placing a retraction cord around
natural teeth.
5. Remove the impression. Verify the marginal integrity of the
impression.
6. Fabricate a provisional crown on the GingiHue Post using
conventional xed prosthodontic techniques and materials. Block out
the screw access opening with wax prior to cementing the crown.
Laboratory
7. Pour the cast in die stone, pin, section and articulate with the
opposing cast.
45
Cement-Retained
GingiHue
Post
Direct Technique (Contd)
8. Wax the single-unit crown coping on the die. Invest, burnout
and cast the coping in a low, medium or high noble alloy. Opaque,
build porcelain, stain and glaze the crown.
Restorative Dentist
9. Remove the provisional crown from the GingiHue Post and
remove all cement. Try the single-unit crown on the abutment and
check the occlusion, marginal t and interproximal contacts. Cement
the crown on the post using temporary or permanent cement.
Remove excess cement.
46
Cement-Retained
ZiReal
Post (All-Ceramic)
Indirect Technique
Restorative Dentist
1. Follow the steps for Implant Level Impressions on pages 9-11
for the Pick-Up Technique and pages 12-14 for the Twist Lock
Transfer Technique.
Laboratory
2. Select the proper ZiReal Post by matching the EP
Diameter of
the healing abutment and matching the color of the implant platform.
Place the ZiReal Post into the implant analog, line up the hex
and press rmly until hearing and feeling the audible and tactile click.
Thread a Certain
Post (All-Ceramic)
Indirect Technique (Contd)
5. Fabricate the all-ceramic crown on the prepared post using
conventional xed prosthodontic techniques and materials.
6. Restorative Dentist
Remove the healing abutment from the implant using a
.048 Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the driver.
Activate the ngers using the QuickSeat
ZiReal Gold-Tite
Hexed Screw
(IZSHG) into the implant until ngertight using the .048 Large
Hex Driver.
Or
Place the prepared ZiReal Post onto the implant, engaging the
hex. Thread a Square Gold-Tite Screw (UNISG) into the implant until
ngertight using the Square Driver (PSQD0N or PSQD1N).
Radiograph the interface to verify an accurate t.
NOTE: The abutment should be placed in the same position as
it was prepared on the cast. A dimple on the facial surface guides
clinicians with accurate placement.
7. Try the single-unit all-ceramic crown on the ZiReal Post and
check the occlusion, marginal t and interproximal contacts.
Torque the Certain ZiReal Gold-Tite Hexed Screw to 20Ncm
using a .048 Large Hex Driver Tip and a torque device.
Or
Torque the Square Gold-Tite Screw to 32-35Ncm using the
Square Driver Tip (RASQ3N or RASQ8N) and a torque device.
Be sure the driver tip is parallel with the access opening to
avoid fracture during torque application.
Place protective material into the screw access opening. Seal
the access opening with composite resin. Cement the crown on the
post using temporary or permanent cement. Remove excess cement.
The ZiReal Post may be etched and the crown bonded, if preferred.
48
Restorative Dentist
1. Select the proper ZiReal Post by matching the EP
Diameter
of the healing abutment and matching the color of the implant
platform. Remove the healing abutment using a .048 Large
Hex Driver (PHD02N or PHD03N). To help prevent accidental
swallowing, thread oss through the spinner on the driver.
Activate the ngers using the QuickSeat
Post (All-Ceramic)
Direct Technique
49
Cement-Retained
ZiReal
Post (All-Ceramic)
Direct Technique (Contd)
5. Remove the impression. Verify the marginal integrity of
the impression.
6. Fabricate a provisional crown on the ZiReal Post using
conventional xed prosthodontic techniques and materials. Cement
the provisional crown using temporary cement.
Laboratory
7. Pour the cast in die stone, pin, section and articulate with the
opposing cast. Fabricate the all-ceramic crown using the all-ceramic
system of choice. Finish and polish the crown.
Restorative Dentist
8. Remove the provisional crown from the ZiReal Post and
remove all cement. Try the single-unit all-ceramic crown on the
ZiReal Post and check the occlusion, marginal t and interproximal
contacts. Cement the crown on the post using temporary or
permanent cement. Remove excess cement. The ZiReal Post may
be etched and the crown bonded, if preferred.
50
Cement-Retained
UCLA Custom Abutment - Single-Unit
Indirect Technique
Material:
Machined Gold Alloy Cylinder
With Plastic Unitube
Restorative Dentist
1. Follow the steps for Implant Level Impressions on pages 9-11
for the Pick-Up Technique and pages 12-14 for the Twist Lock
Transfer Technique.
Laboratory
2. Deactivate the ngers on the Certain
Gold-Tite
Transfer Technique.
Laboratory
2. Deactivate the ngers on the Certain
Gold-Tite
Transfer Technique.
Laboratory
2. Deactivate the ngers on the Certain
Gold-Tite
Transfer Technique.
Laboratory
2. Deactivate the ngers on the Certain
Transfer Technique.
Laboratory
7. Place a Hexed Low Prole Gold or Castable Cylinder onto
the Low Prole analog. Thread with a Low Prole Waxing Screw
(LPCWS) or the Low Prole Gold-Tite
Transfer Technique.
Laboratory
7. Place a Non-Hexed Low Prole Gold Cylinder or Castable
Cylinder onto the Low Prole analogs. Thread with Low Prole
Waxing Screws (LPCWS) or Low Prole Gold-Tite
Retaining Screws
(LPCGSH) into the analog until ngertight using a .048 Large Hex
Driver (PHD02N or PHD03N). Reduce or adjust the plastic sleeves
as necessary. Wax the multiple-unit porcelain-fused-to-metal (PFM)
framework to the waxing sleeves.
8. Remove the Low Prole Waxing or Retaining Screw and
carefully remove the wax coping from the Low Prole Analog.
Invest, burnout and cast the coping to the Low Prole Gold Cylinder
using a low, medium or high noble alloy (see page 7 for casting alloy
specications). Divest and nish the coping. Return to the restorative
dentist for the metal framework try in.
64
Screw-Retained
Low Prole Abutment - Multiple-Unit
Indirect Technique (Contd)
Restorative Dentist
9. Remove the healing caps from the abutments using a .048
Large Hex Driver (PHD02N or PHD03N). Place the multiple-unit
framework onto the abutments. Thread a Low Prole Gold-Tite
Retaining Screw (LPCGSH) into the posterior most abutment using
a .048 Large Hex Driver (PHD02N or PHD03N). Radiograph
the interface on the abutments. Repeat after removing the screw
and placing it into the anterior most abutment. Cut and index the
framework intraorally if a t discrepancy is found. If the framework
does not t the implant(s); cut and index the framework. Return the
framework to the laboratory for soldering or welding. Repeat the
metal try in to make sure an accurate and passive t is obtained. Take
another radiograph to access the t between the framework and
implants. Immediately replace the healing caps on the abutments.
Laboratory
10. Place the veried framework back onto the Low Prole
Analogs in the cast and thread Low Prole Waxing Screws (LPCWS)
or Low Prole Gold-Tite Retaining Screws (LPCGSH) into the analogs
until ngertight. Opaque and build porcelain on the multiple-unit
framework. Stain and glaze the porcelain. Polish the gold collars with
polishing protectors in place.
Restorative Dentist
11. Remove the healing caps from the abutments. Place the
multiple-unit prosthesis onto the abutments. Thread Low Prole
Gold-Tite Retaining Screws into the abutments until ngertight using
a .048 Large Hex Driver (PHD02N or PHD03N). Radiograph
the interface on the abutments to verify a passive t. Verify the
interproximal contacts and the occlusion. Torque the screws to
10Ncm using a .048 Large Hex Driver Tip (RASH3N or RASH8N)
and a torque device. Place protective material into the screw access
openings. Seal the access openings with temporary lling material and
composite resin. Make any occlusal adjustments necessary.
65
Screw-Retained
Conical Abutment - Single-Unit
Indirect Technique
Material:
Titanium Alloy
Commercially Pure Titanium
Surgeon Or Restorative Dentist
1. Select the proper Conical Abutment collar height and angle
(0, 17 or 25) for the implant by measuring the height of the
healing abutment above the tissue, not including the domed portion.
Subtract the measurement from the total height of the healing
abutment and subtract 2mm. Match the color of the implant platform.
See page 16 for the Prosthetic Abutment Selection Guide.
2. Remove the healing abutment from the implant using a
.048 Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the driver.
3. Activate the ngers using the QuickSeat
Transfer Technique.
Laboratory
7. Place a Hexed Conical Gold or Castable Cylinder onto the
conical analog. Thread with a Waxing Screw (WSK10 or WSK15)
or Hexed Gold-Tite
Transfer Technique.
Laboratory
7. Place the Non-Hexed Conical Gold or Castable Cylinders
onto the Conical Analogs and thread Waxing Screws (WSK10 or
WSK15) or Hexed Gold-Tite
Retaining Screw (GSHxx) into the
analogs until ngertight using a .048 Large Hex Driver (PHD02N
or PHD03N). Reduce or adjust the plastic sleeves as necessary.
Wax the multiple-unit framework to the waxing sleeves.
8. Remove the retaining or waxing screws and carefully remove
the wax framework from the analogs. Invest, burnout and cast
the multiple-unit framework to the Conical Gold Cylinders using
a low, medium or high noble alloy (see page 7 for casting alloy
specications). Divest and nish the framework. Return to the
restorative dentist for the metal framework try in.
70
Screw-Retained
Conical Abutment - Multiple-Unit
Indirect Technique (Contd)
Restorative Dentist
9. Remove the healing caps from the abutments. Place the
multiple-unit framework onto the abutments. Thread a Hexed Gold-
Tite
Provisional Components
Indirect Technique
Clinician
1. Prior to placing the abutments, make an interocclusal
registration with the patient in centric occlusion. This is made with the
patients existing denture.
NOTE: One piece interocclusal registrations (one U shaped
interocclusal record) are easier to handle than two individual
(right and left segments) interocclusal registrations. Two
interocclusal registrations can be mixed up (right and left; up and
down). One piece interocclusal registrations are much easier to
orient correctly in the mouth.
2. After placing the proper Low Prole Abutments, thread
a QuickBridge Titanium Cylinder onto each of the abutments
and hand tighten using a .048 Large Hex Driver (PHD02N or
PHD03N). Torque the cylinders to 10Ncm using a .048 Large Hex
Driver Tip (RASH3N or RASH8N) and a torque device. Try in the
denture and make sure that the vertical dimension of occlusion is
not increased (the denture seats freely onto the titanium cylinders).
Adjust the denture until all interferences from the cylinders have been
eliminated. Place fast setting impression material onto the intaglio
surface of the denture, insert it into the mouth and press lightly
over the QuickBridge Titanium Cylinder assemblies to mark their
locations. Allow the impression material to set per the manufacturers
instructions. The patient should be in centric occlusion during this
step; the midline should be consistent with the facial midline; the
occlusal plane should be horizontal.
3. Remove the denture from the mouth. The locations of the
cylinders will be identied in the impression material. Remove the
impression material from the denture. Drill holes completely through
the denture base and denture teeth with a large round bur. Enlarge
the holes with an acrylic bur so that the QuickBridge Components do
not interfere with the denture base. Make sure the vertical dimension
of occlusion has not been changed.
72
4. Snap the QuickBridge Caps onto the QuickBridge Titanium
Cylinders. Try in the denture over the QuickBridge Caps to verify
that there are no interferences and it is completely seated.
Place self curing acrylic resin into the retention facets on each
QuickBridge Cap and ll the relieved areas of the denture with acrylic
resin. Seat the denture over the QuickBridge Caps and have the
patient close into occlusion using the interocclusal registration. Verify
that the denture is completely seated and that the vertical dimension
of occlusion has not been changed. Allow the acrylic resin to set
per the manufacturers instructions. The maxillary midline should be
consistent with the facial midline.
NOTE: If this is performed immediately following implant
placement for immediate occlusal loading, cut and place a rubber
dam around the QuickBridge Titanium Cylinders prior to relining
the denture with acrylic resin.
5. Remove the denture from the mouth. The QuickBridge
Caps will remain inside the denture. Remove the palate and anges
from the denture using an acrylic bur. Fill in any voids around the
QuickBridge Caps with self curing acrylic resin. Be careful not to
let any resin ow into the QuickBridge Caps that will interfere
with seating over the QuickBridge Titanium Cylinders. Finish and
polish the denture. Place a small amount of temporary cement
into the QuickBridge Caps and seat the provisional prosthesis
on the QuickBridge Titanium Cylinders. Have the patient close
into occlusion. Remove excess cement from around the margin
areas of each cap. Allow the cement to set per the manufacturers
instructions. Adjust the occlusion as necessary.
Denture Conversion To Fixed Prosthesis
QuickBridge
Provisional Components
Indirect Technique (Contd)
73
Clinician
1. Make an impression of the patients existing xed prosthesis
or denture and the opposing arch. Make an occlusal registration with
quick setting polyvinlysiloxane impression material.
Laboratory
2. Pour stone casts of the impressions. Articulate the stone casts
using the interocclusal registration.
3. Make a vacuum formed template over the stone cast.
A 2mm thick exible vacuum formed material is recommended.
Remove the template from the stone cast and trim away excess
material. Leave the palate and anges on the template. Make an
interocclusal registration between the template and the opposing cast
using the articulator.
Clinician
4. Fill the tooth portion of the vacuum formed template with
impression material and place it in the mouth over the Low Prole
Abutments. Have the patient close into the interocclusal registration
and allow the impression material to set. Remove the impression
material from the template. Place the impression material replica of
the teeth in the mouth and verify the occlusion and tooth position. Set
aside the replica of the teeth for the laboratory to use as a guide when
fabricating the denitive restoration.
5. The Low Prole Abutments should be torqued to 20Ncm.
Thread a QuickBridge Titanium Cylinder onto each of the Low
Prole Abutments and hand tighten using a .048 Large Hex Driver
(PHD02N or PHD03N). Torque the cylinders to 10Ncm using a
.048 Large Hex Driver Tip (RASH3N or RASH8N) and a torque
device. Snap the QuickBridge Caps onto the QuickBridge
Titanium Cylinders.
Denture Conversion To Fixed Prosthesis
QuickBridge
Provisional Restoration
Indirect Technique
74
Denture Conversion To Fixed Prosthesis
QuickBridge
Provisional Restoration
Indirect Technique (Contd)
6. Add self curing acrylic resin into the retention facets on the
QuickBridge Caps and into the tooth portion of the template. Place
the template into the mouth over the QuickBridge Caps and have the
patient close into the interocclusal registration. Allow the acrylic resin
to set per the manufacturers instructions.
NOTE: Irrigate with water during polymerization. Be aware of
the amount of heat generated by the acrylic resin during setting
and polymerization.
7. Remove the template from the mouth. The QuickBridge Caps
will remain in the acrylic resin. Be careful to not let any resin ow
into the QuickBridge Caps that will interfere with seating over the
QuickBridge Titanium Cylinders. Remove the provisional prosthesis
from the template. Remove the excess acrylic resin from around the
margin areas and ll in any voids. Finish the provisional restoration to
the desired contour and polish.
8. Place the provisional restoration into the mouth and snap
the QuickBridge Caps onto the Titanium Cylinders. Verify the t
and aesthetics. Adjust the occlusion as necessary. Remove the
provisional restoration. Place a small amount of temporary cement
into the QuickBridge Caps and seat the provisional prosthesis on
the QuickBridge Titanium Cylinders. Have the patient close into
occlusion. Remove excess cement from around the margin areas of
each cap. Allow the cement to set per the manufacturers instructions.
Adjust the occlusion as necessary.
NOTE: If this is performed immediately following implant
placement for immediate occlusal loading, cut and place a rubber
dam around the QuickBridge Titanium Cylinders.
75
Bar Supported Overdenture
Standard Abutment Hader Bar
Material:
Titanium Alloy
Commercially Pure Titanium
Surgeon Or Restorative Dentist
1. Select the proper Standard Abutment collar height for each
implant by measuring the height of the healing abutment above the
tissue, not including the domed portion. Subtract the measurement
from the total height of the healing abutment and add 1mm. Match
the color of the implant platform.
2. Remove the healing abutments from the implants, one at a
time, using a .048 Large Hex Driver (PHD02N or PHD03N).
To help prevent accidental swallowing, thread oss through the
spinner on the driver.
3. Place the proper height Standard Abutment into the implant
and thread into place until ngertight.
Or
Place the proper height Standard Abutment collar onto the
implant, engaging the hex and thread the Standard Abutment Screw
into the implant by turning the spindle on the ASYST
Tool until
ngertight. Remove the ASYST Tool.
4. Radiograph the interfaces to verify complete seating of the
abutments on the implants. Place the lm perpendicular to the
interface of the abutment on the implant.
SEATED NOT SEATED
Indications:
Multiple Implant, Bar Retained and Removable Overdentures
Minimum Space For Bar Construction is 9-11mm
Maximum Divergence of 30
76
Bar Supported Overdenture
Standard Abutment Hader Bar (Contd)
5. Torque the Standard Abutment Screws into the implants at
20Ncm using the Abutment Driver Tip and a torque device. If the
surgeon places the abutments, Standard Abutment Healing Caps are
then threaded onto the abutments using a .048 Large Hex Driver
(PHD02N or PHD03N). The patients existing denture is then
relieved to be supported by the abutments. A tissue conditioning
material is sometimes necessary for retention and support of the
overdenture. The abutment caps are not designed to provide
retention for the overdenture.
Pick-Up Impression Technique
(See page 78 for Transfer Impression Technique)
Restorative Dentist-Pick-Up Technique
6a. Place the Standard Abutment Pick-Up Impression Copings
onto the abutments. Thread the coping screws into the abutments
until ngertight using a .048 Large Hex Driver (PHD02N or
PHD03N). Visually verify all copings are seated passively on the
abutments. Impression copings may be splinted prior to the
denitive impression.
7a. A custom or stock open impression tray is used for the
Pick-Up Impression Technique. Cut small holes in the tray for the
screws to protrude through. Try in the tray to verify that the screw
heads are visible through the openings.
NOTE: If the impression is to be used to fabricate the
overdenture, a custom impression tray should be made.
8a. Syringe regular or injection viscosity impression material
around the impression copings, load the impression tray with
medium or heavy body impression material and seat it in the
mouth. Allow the impression material to set per the
manufacturers instructions.
77
Bar Supported Overdenture
Standard Abutment Hader Bar (Contd)
9a. Load the impression tray and seat it in the mouth. Wipe
impression material off the top of the screws before it sets. Allow
the impression material to set per the manufacturers instructions.
10a. After the impression material has set, unscrew and remove
the Pick-Up Impression Coping Screws using the .048 Large Hex
Driver. Remove the impression from the mouth.
11a. Verify that the impression material has completely adapted
around each of the copings and that the copings are not mobile
within the impression. If any copings are loose, the impression
should be repeated.
12a. Replace the Standard Abutment Healing Caps onto the
abutments using the .048 Large Hex Driver (PHD02N or
PHD03N). Reline the patients existing denture with a soft reline
material over the abutments and healing caps.
78
Bar Supported Overdenture
Standard Abutment Hader Bar (Contd)
13a. Laboratory
Place the Standard Abutment Lab Analogs into the
impression copings and hold them in position while tightening the
screws. Verify that the analogs are completely seated.
NOTE: In some cases, it may be necessary to place soft-tissue
replication material around the impression coping/analogs
prior to pouring the stone cast. Check with your laboratory for
specic procedures.
14a. Pour the cast in die stone. After the stone has set, loosen
the screws using a .048 Large Hex Driver (PHD02N or PHD03N)
until these disengage from the analogs. Remove the impression
from the stone cast. Go to Step 15.
Transfer Impression Technique
Restorative Dentist
6b. Thread the Standard Abutment Transfer Copings into
the abutments until ngertight; then tighten using the Transfer
Impression Coping Driver (ICD00). Visually verify that all copings
are completely seated on the abutments.
7b. A custom or stock closed top impression tray is used for
the transfer impression technique. Allow for approximately 2mm of
space between the tray and the top of the copings. The copings are
9mm in height.
NOTE: If the impression is to be used to fabricate the
overdenture, a custom impression tray should be made.
79
Bar Supported Overdenture
Standard Abutment Hader Bar (Contd)
8b. Syringe regular or injection viscosity impression material
around the impression copings, load the impression tray with
medium or heavy body impression material and seat it in the
mouth. Allow the impression material to set per the
manufacturers instructions.
9b. Load the impression tray and seat it in the mouth. Allow the
impression material to set per the manufacturers instructions.
10b. After the impression material has set, remove the impression
from the mouth. The transfer impression copings will stay on the
abutments in the mouth. Verify that the material completely adapted
around each of the copings.
11b. Remove the transfer impression copings from the abutments.
80
Bar Supported Overdenture
Standard Abutment Hader Bar (Contd)
12b. Replace the Standard Abutment Healing Caps onto the
abutments using a .048 Large Hex Driver (PHD02N or PHD03N).
Reline the patients existing denture with a soft reline material over
the abutments and healing caps.
Laboratory
13b. Screw the transfer copings onto the Standard Abutment
Analogs and verify that these are passively seated. Holding on to
the analog, press each transfer coping rmly into the impression.
The coping is fully seated when the retentive groove engages.
14b. Pour the cast in die stone. After the stone has set, remove
the impression from the cast. Unscrew the transfer copings from
the analogs. Go to Step 15.
NOTE: In some cases, it may be necessary to place soft-tissue
replication material around the impression coping/analogs
prior to pouring the stone cast. Check with your laboratory for
specic procedures.
15. Place the Standard Abutment Gold or Non-Hexed Castable
Cylinders onto the Standard Abutment Analogs and thread Waxing
Screws (WSK10 or WSK15) or Hexed Gold-Tite
Retaining Screws
(GSHxx) into the analogs until ngertight using a .048 Large Hex
Driver (PHD02N or PHD03N). Non-Hexed Pick-up Impression
Copings may also be used for this step. Fabricate a verication index
by luting the plastic sleeves together using a low expansion light cure
composite resin or autopolymerizing acrylic resin. It is often helpful
to fabricate a record base and occlusion rim at this step to facilitate
jaw relation records.
NOTE: If using autopolymerizing acrylic resin, allow at least 24
hours to polymerize prior to using.
81
Bar Supported Overdenture
Standard Abutment Hader Bar (Contd)
Restorative Dentist
16. Remove the healing caps using the .048 Large Hex Driver
(PHD02N or PHD03N). Place the record base and occlusion rim
in the mouth, over the abutments. Make the interocclusal records.
Place the verication index onto the abutments. Place a Hexed
Gold-Tite
Bars &
Frameworks Manual (ART868).
82
Bar Supported Overdenture
Standard Abutment Hader Bar (Contd)
20. Carefully remove the Standard Abutment Gold or Castable
Cylinders from the verication index. Place the cylinders onto the
analogs and thread Waxing Screws (WSK10 or WSK15) into the
analogs until ngertight. Adjust the height of the sleeves as necessary.
Wax the bar patterns (and attachments, if used) to the waxing
sleeves. Use the matrix on the cast to position the bar within the
connes of the wax denture.
NOTE: Adequate space is required for the bar, attachments,
denture base and denture teeth.
21. Remove the Hader Bar wax pattern from the cast. Invest,
burnout and cast the bar in a low, medium or high noble alloy (see
page 7 for casting alloy specications). Divest, nish and polish the bar
with polishing protectors in place. Return the bar to the restorative
dentist for try in and t verication.
Restorative Dentist
22. Remove the healing caps from the abutments. Place the bar
onto the abutments. Thread a Hexed Gold-Tite
Retaining Screw
(GSHxx) into one posterior-most abutment and ngertighten. Visually
verify that the bar is seated passively on all abutments. Repeat after
removing the screw and placing it into the opposite posterior-
most abutment. If a t discrepancy is found, cut and index the bar
intraorally for soldering. Replace the healing caps.
Laboratory
23. Transfer the denture teeth back onto the cast using the
matrix and wax the denture for processing. Flask the waxed denture
and boil out. Separate the ask and attach the Hader Bar onto the
analogs in the cast using retaining screws. Block out all undercuts
and access openings with wax. Place the Hader clips and/or other
attachments onto the bar. Process and nish the denture following
conventional procedures.
83
Bar Supported Overdenture
Standard Abutment Hader Bar (Contd)
Restorative Dentist
24. Remove the healing caps. Place the Hader Bar onto the
abutments. Thread the Hexed Gold-Tite
Transfer Technique.
Laboratory
2. Follow the steps on pages 81-82 for fabrication of the
verication index, record base and wax occlusion rim, wax try-in and
plaster or silicone matrix.
Or
If the clinician and/or laboratory technician would like to use CAD/
CAM technology, request a Bar. See the BellaTek
Bars &
Frameworks Manual (ART868).
3. Carefully remove the Low Prole Abutment Gold or Castable
Cylinders from the verication index. Place the cylinders onto the
analogs and attach with Low Prole Waxing Screws (LPCWS) using a
.048 Large Hex Driver (PHD02N or PHD03N). Adjust the height
of the sleeves as necessary. Wax the hybrid bar pattern to the waxing
sleeves and add acrylic resin retention to the occlusal surface of the
wax pattern. Use the matrix on the cast to position the bar within the
connes of the wax denture.
4. Remove the hybrid bar wax pattern from the cast. Invest,
burnout and cast the bar in a low, medium or high noble alloy (see
page 7 for casting alloy specications). Divest, nish and polish the
tissue surface of the bar with polishing protectors in place. Return the
bar to the restorative dentist for try in and t verication.
85
Restorative Dentist
5. Remove the healing caps from the abutments using a .048
Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the driver.
Place the bar onto the abutments. Thread a Low Prole Hexed Gold-
Tite
Transfer Technique.
Laboratory
2. Follow the steps on pages 81-82 for fabrication of the
verication index, record base and wax occlusal rim, wax try-in and
plaster or silicone matrix.
Or
If the clinician and/or laboratory technician would like to use CAD/
CAM technology, request a Bar. See the BellaTek
Bars &
Frameworks Manual (ART868).
3. Carefully remove the Standard Abutment Gold or Castable
Cylinders from the verication index. Place the cylinders onto the
analogs and attach with Waxing Screws (WSK10 or WSK15) using a
.048 Large Hex Driver (PHD02N or PHD03N). Adjust the height
of the sleeves as necessary. Wax the hybrid bar pattern to the waxing
sleeves and add acrylic resin retention to the occlusal surface of the
wax pattern. Use the matrix on the cast to position the bar within the
connes of the wax denture.
4. Remove the hybrid bar wax pattern from the cast. Invest,
burnout and cast the bar in a low, medium or high noble alloy (see
page 7 for casting alloy specications). Divest, nish and polish the
tissue surface of the bar with polishing protectors in place. Return the
bar to the restorative dentist for try in and t verication.
87
Implant-Retained Fixed Prosthesis
Standard Abutment Fixed Hybrid (Contd)
Restorative Dentist
5. Remove the healing caps from the abutments using a .048
Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the
driver. Place the bar onto the abutments. Thread a Hexed Gold-
Tite
Transfer Technique.
Laboratory
2. Place the Non-Hexed Gold or Castable UCLA Abutments
onto the implant analogs and thread Try-in Screws (IUNITS or
UNITS) or Waxing Screws (WSK10 or WSK15) into the analogs until
ngertight using a .048 Large Hex Driver (PHD02N or PHD03N).
Fabricate a verication index by luting the plastic sleeves together
using a low expansion light cure composite resin or autopolymerizing
acrylic resin. Also, fabricate a record base and occlusion rim.
Restorative Dentist
3. Place the record base and occlusion rim over the healing
abutments. Make the interocclusal records using the clinicians
preferred method. Remove the healing abutments using a .048
Large Hex Driver (PHD02N or PHD03N). To help prevent
accidental swallowing, thread oss through the spinner on the driver.
Place the record base and occlusion rim over the UCLA Abutments.
Make the interocclusal records. Place the verication index onto
the abutments. Place a Try-in Screw (IUNITS or UNITS) into one
posterior-most UCLA Abutment and ngertighten. Visually verify
that all cylinders are seated passively and completely on the implants.
Remove the screw and place it into the opposite posterior-most
UCLA Abutment and repeat. If a t discrepancy is found, section the
index into individual segments and reassemble intraorally. Splint the
segments together with autopolymerizing acrylic resin and allow it to
set. Remove the index and return it to the laboratory for re-tting of
the master cast. Immediately replace the healing abutments.
Laboratory
4. Verify that the analog positions on the cast are accurate
using the verication index. Articulate casts using the interocclusal
record. Set denture teeth on the record base and wax for try in.
If the verication index needs to be modied, remove the inaccurate
analog(s) from the cast and attach it to the verication index. Re-seat
the index on the other remaining analogs into the cast. Verify that the
analog does not touch the stone of the cast. Inject a mix of die stone to
re-attach the analog back into the cast. The cast has now been veried.
Indications:
Multiple Implant Bar Retained and Removable Overdentures
Minimum Space For Bar Construction is 9-11mm
Maximum Angulation Correction of 30
89
Bar Supported Overdenture
UCLA Abutment Hader Bar (Contd)
Restorative Dentist
5. Place the wax denture into the mouth. Verify the occlusion,
aesthetics and phonetics. Make any adjustments necessary. If major
adjustments are necessary, make a new interocclusal record and
return it to the laboratory for a new articulator mounting, wax
denture and try in.
Laboratory
6. Make a plaster or silicone matrix of the veried wax try-in
and remove the denture teeth inside it. Wax and cast the
framework consistent with xed and removeable prosthodontic
design parameters.
Or
If the clinician and/or laboratory technician would like to use CAD/
CAM technology, request a Bar. See the BellaTek
Bars &
Frameworks Manual (ART868).
7. Carefully remove the UCLA Abutments from the verication
index. Place the UCLA Abutments onto the implant analogs and
thread waxing screws into the analogs until ngertight using a .048
Large Hex Driver (PHD02N or PHD03N). Adjust the height of the
sleeves as necessary. Wax the bar patterns (and attachments, if used)
to the waxing sleeves. Use the matrix on the cast to position the bar
within the connes of the wax try-in.
NOTE: Adequate space (9-11mm) is required for the implant
restorative components, denture base and denture teeth.
8. Remove the Hader Bar wax-up from the cast. Invest, burnout
and cast the Hader Bar in a low, medium or high noble alloy (see
page 7 for casting alloy specications). Divest, nish and polish the bar
with polishing protectors in place. Return the bar to the restorative
dentist for try in and t verication.
90
Bar Supported Overdenture
UCLA Abutment Hader Bar (Contd)
Restorative Dentist
9. Remove the healing abutments from the implants. Place the
bar onto the implants. Thread a Try-in Screw (IUNITS or UNITS)
into one posterior-most implant. Radiograph the interfaces to verify
that the bar is seated passively on all implants. Repeat after removing
the screw and placing it into the opposite posterior-most implant. If a
t discrepancy is found, cut and index the bar intraorally for soldering.
Immediately replace the healing abutments on the implants.
Laboratory
10. Transfer the denture teeth back onto the cast using the matrix
and wax the denture for processing. Flask the waxed denture and
boil out. Separate the ask and attach the Hader Bar onto the
analogs in the cast using try-in screws. Block out all undercuts and
access openings with plaster. Place the Hader clips and/or other
attachments onto the bar. Process and nish the denture following
conventional procedures.
Restorative Dentist
11. Remove the healing abutments from the implants. Place the
Hader Bar onto the implants.
Thread a Certain
Gold-Tite
Transfer Technique.
Laboratory
2. Place the Non-Hexed Gold or Castable UCLA Abutments
onto the implant analogs and thread Try-in Screws (IUNITS or
UNITS) or Waxing Screws (WSK10 or WSK15) into the analogs until
ngertight using a .048 Large Hex Driver (PHD02N or PHD03N).
Fabricate a verication index by luting the plastic sleeves together
using a low expansion light cure composite resin or autopolymerizing
acrylic resin. Also, fabricate a record base and wax occlusion rim.
Restorative Dentist
3. Remove the healing abutments using a .048 Large Hex
Driver (PHD02N or PHD03N). To help prevent accidental
swallowing, thread oss through the spinner on the driver. Place
the occlusion rim into the mouth. Make the interocclusal records.
Place the verication index onto the implants. Thread a Try-in Screw
(IUNITS or UNITS) into one posterior-most UCLA Abutment and
ngertighten. Radiograph the interfaces to verify that all cylinders
are seated passively on the implants. Remove the screw and place
it into the opposite posterior-most UCLA Abutment and repeat. If a
t discrepancy is found, section the index and reassemble intraorally.
Remove the index. Immediately replace the healing abutments.
Laboratory
4. Verify that the analog positions on the cast are accurate using
the verication index. If a t discrepancy is found, remove the analog
and replace it in the cast using the verication index. Articulate the
casts using the interocclusal record. Set the denture teeth on the
record base to rst molar occlusion only and wax for try in.
92
Implant-Retained Fixed Prosthesis
UCLA Abutment Fixed Hybrid (Contd)
Restorative Dentist
5. Place the wax try-in into the mouth. Verify the occlusion,
aesthetics and phonetics. Make any adjustments necessary. If major
adjustments are necessary, make a new interocclusal record and
return to the laboratory for a new set up and try-in.
Laboratory
6. Make a plaster or silicone matrix of the veried wax try-in and
remove the denture teeth inside it.
Or
If the clinician and/or laboratory technician would like to use CAD/
CAM technology, request a Bar. See the BellaTek
Bars &
Frameworks Manual (ART868).
7. Carefully remove the UCLA Abutments from the verication
index. Place the Non-Hexed UCLA Abutments onto the implant
analogs and thread Try-in Screws (IUNITS or UNITS) or Waxing
Screws (WSK10 or WSK15) into the analogs until ngertight using a
.048 Large Hex Driver (PHD02N or PHD03N). Adjust the height
of the plastic sleeves as necessary. Wax the hybrid bar patterns to
the wax sleeves and add acrylic resin retention on the top. Use the
matrix on the cast to position the bar within the connes of the
wax try-in.
8. Remove the hybrid bar wax pattern from the cast. Invest,
burnout and cast the bar in a low, medium or high noble alloy (see
page 7 for casting alloy specications). Divest, nish and polish the
tissue surface of the bar with polishing protectors in place. Return the
bar to the restorative dentist for try in and t verication.
93
Implant-Retained Fixed Prosthesis
UCLA Abutment Fixed Hybrid (Contd)
Restorative Dentist
9. Remove the healing abutments from the implants. Place the
bar onto the implants. Thread a try-in screw into one posterior-
most implant. Radiograph the interface of all implants. Repeat after
removing the screw and placing it into the opposite posterior-most
implant. If a t discrepancy is found, cut and index the bar intraorally
for soldering. Immediately replace the healing abutments on
the implants.
Laboratory
10. Attach the bar onto the implant analogs with waxing screws
using a .048 Large Hex Driver (PHD02N or PHD03N). Transfer
the denture teeth from the matrix onto the bar on the cast and wax
the hybrid prosthesis for processing. Flask the waxed prosthesis
and boil out. Separate the ask. Opaque the bar in areas where the
acrylic resin will be processed to it. Block out all undercuts between
the framework and cast with plaster. Process and nish the hybrid
prosthesis in a conventional manner. Polishing protectors should be in
place during all nishing and polishing procedures.
Restorative Dentist
11. Remove the healing abutments from the implants. Place the
Fixed Hybrid prosthesis onto the implants.
Thread a Certain
Gold-Tite
Abutment
Indirect Technique
Indications:
Tissue Supported Removable Overdentures on Two to Four Implants
Minimum Interarch Distance of 4mm
Angle Correction With Up to 40 Between Divergent Implants
95
Tissue Supported Overdenture
LOCATOR
Abutment
Indirect Technique (Contd)
5. Torque the LOCATOR Abutments into the implants at
20Ncm, using the LOCATOR Core Tool/Abutment Driver
(LCTDR1) and a .050 inch hexed driver tip in a torque device. (If the
surgeon places the abutments, the patients existing denture will be
relieved to allow for the abutments.)
Or
Place the LOCATOR Driver Tip (LOADT) into the torque device
and torque the abutments to 20Ncm.
Restorative Dentist
6. A custom or stock closed impression tray may be used.
Provide relief for the height of the LOCATOR Abutments and
impression copings plus 2mm. The impression copings are 4.5mm
in height.
NOTE: If the impression is to be used to fabricate the
overdenture, a custom impression tray should be made.
7. Place the LOCATOR Impression Copings (LAIC1) on the
abutments and verify complete seating. Use injection viscosity
impression material to inject the material around the attachments
intraorally. Use medium or heavy body viscosity impression material
for the tray.
NOTE: Sometimes it is helpful to place impression adhesive on
the impression copings to ensure their removal in the impression.
8. Load the impression tray and seat it in the mouth. Allow the
impression material to set per the manufacturers instructions.
96
Tissue Supported Overdenture
LOCATOR
Abutment
Indirect Technique (Contd)
9. Remove the impression from the mouth and verify that the
impression material completely adapted around each coping. The
impression copings should remain inside the impression. Relieve the
patients existing denture to allow for the LOCATOR Abutments.
Place a chairside soft liner into the denture around the abutments
and seat the denture. Have the patient close into centric occlusion.
Allow the soft liner to set per the manufacturers instructions.
Laboratory
10. Insert the LOCATOR Laboratory Analogs (LALA1) into the
impression copings using rm pressure until these fully engage.
11. Pour the cast in die stone, being careful to not dislodge the
analogs. Fabricate a record base and wax occlusion rim.
Restorative Dentist
12. Place the occlusion rim into the mouth. Make the
interocclusal records.
97
Tissue Supported Overdenture
LOCATOR
Abutment
Indirect Technique (Contd)
Laboratory
13. Articulate casts using the interocclusal record. Set the denture
teeth on the record base for the wax try in.
Restorative Dentist
14. Place the wax denture into the mouth. Verify occlusion,
aesthetics and phonetics. Make any adjustments necessary. If major
adjustments are necessary, make a new interocclusal record and
return to the laboratory for a new articulator mounting, wax denture
and try-in.
Laboratory
15. After the wax try-in is veried, ask the denture on the
cast. Boil out the wax and separate the ask. Place the LOCATOR
White Spacer Rings over the analogs to prevent acrylic resin from
owing under the housings. Place the Housing/Black Processing Male
Attachment assemblies onto the analogs.
16. Process and nish the denture with the LOCATOR Housings
in place. Remove the Black Processing Males and replace with Final
Male Attachments (see step 18).
98
Tissue Supported Overdenture
LOCATOR
Abutment
Indirect Technique (Contd)
Restorative Dentist
17. Remove the Black Processing Male by placing the Removal Tip
end of the LOCATOR Core Tool/Abutment Driver (LCTDR1) into
the Housing/Black Processing Male assembly and turning the spinner
three rotations counter clockwise. Place the Final Male Attachment
on the attachment insertion end of the Core Tool and press it rmly
into the housing. The attachment retention on the abutment may
be reduced by placing the pink Light
Retention Male or the blue Extra Light
Retention Male rather than the clear Final
Male. The male attachments are replaced
after normal wear by inserting the
Removal Tip straight into the bottom of
the nylon male. Tilt the tool so the sharp
edge will grab hold of the male and pull it
out of the cap.
18. Place the overdenture onto the LOCATOR Abutments in
the mouth, engaging the attachments. Make any occlusal or tissue
adjustments necessary. Instruct the patient on insertion, removal,
maintenance and oral hygiene of the prosthesis.
Male Attachments:
1lb. of retention
LAELM
3lb. of retention
LLRMS
5lb. of retention
LARMS
99
Tissue Supported Overdenture
LOCATOR
Abutment
Direct Technique
Restorative Dentist
1. Follow steps 1-5 on pages 94-95 for LOCATOR Abutment
Indirect Technique selection and placement.
2. A direct chairside processing technique may be used for a
patients existing denture or a new denture by cutting relief and
lingual vent windows in the acrylic resin denture base over the
abutment areas.
3. Cut two small pieces of rubber dam and place a hole in
the center of each. Place these over the abutments to protect the
tissue. Place the White Spacer Rings over the LOCATOR Abutments
to prevent acrylic resin from owing into undercuts around the
housings. Place the Housing/Black Processing Male Attachment
assemblies onto the LOCATOR Abutments in the mouth. Try in
the denture over the housings to verify it is fully seated on the ridge
and the housings are not in contact with the denture. Eliminate all
contacts between the LOCATOR Abutments and denture base.
4. Place autopolymerizing acrylic resin or light cure composite
resin over the LOCATOR Housings and into relief areas of the
denture. Place the denture into position in the mouth and have the
patient close into centric occlusion. Allow the acrylic resin to set per
the manufacturers instructions.
100
Tissue Supported Overdenture
LOCATOR
Abutment
Direct Technique (Contd)
5. Remove the Black Processing Male by placing the Removal
Tip end of the LOCATOR Core Tool/Abutment Driver (LCTDR1)
into the Housing/Black Processing Male assembly and turning the
spinner three rotations counter clockwise. Place the Final Male
Attachment on the attachment insertion end of the Core Tool and
press it rmly into the housing. The
attachment retention on the abutment
may be reduced by placing the pink Light
Retention Male or the blue Extra Light
Retention Male rather than the clear
Final Male. The male attachments are
replaced after normal wear by inserting
the Removal Tip straight into the bottom
of the nylon male. Tilt the tool so the
sharp edge will grab hold of the male
and pull it out of the cap.
6. Remove the denture, ll any voids with a new mix of acrylic or
composite resin around the housings and polish. Remove the Black
Processing Males and replace these with the Final Male Attachments
(see step 5). Place the overdenture onto the LOCATOR Abutments
in the mouth, engaging the attachments. Make any occlusal or tissue
adjustments necessary. Instruct the patient on insertion and removal
of the prosthesis and oral hygiene maintenance.
Male Attachments:
1lb. of retention
LAELM
3lb. of retention
LLRMS
5lb. of retention
LARMS
101
Tissue Supported Overdenture
Dal-Ro Abutment
Indirect Technique
Material:
Abutment: Titanium Alloy
Housing: Titanium
Females: Gold Alloy
Surgeon Or Restorative Dentist
1. Select the proper Dal-Ro Abutment collar height for each
implant by measuring the height of the healing abutment above the
tissue, not including the domed portion. Subtract the measurement
from the total height of the healing abutment and add 1mm.
2. Remove the healing abutments from the implants, one at a
time, using a .048 Large Hex Driver (PHD02N or PHD03N). To
help prevent accidental swallowing, thread oss through the spinner
on the driver.
3. Place the proper height Dal-Ro Abutment collar onto the
implant, engaging the hex. Thread the Dal-Ro Abutment Screw into
the implant by engaging the hex below the ball with the O-Ring/
Dal-Ro Driver (PAD01). Fingertighten the screws.
4. Radiograph the interfaces to verify complete seating of the
abutments on the implants. Place the lm perpendicular to the
interface of the abutment on the implant.
Indications:
Tissue Supported Overdentures on Two to Four Implants
Overdentures with One or More Implants
Minimum Interarch Space of 5mm
Maximum Tissue Height of 6mm
Recommended for Parallel Implants;
(See Castable Dal-Ro System for Divergent Implants)
2501000 Grams of Retention; May Be Adjusted
SEATED NOT SEATED
102
Tissue Supported Overdenture
Dal-Ro Abutment
Indirect Technique (Contd)
5. Torque the Dal-Ro Abutment Screws into the implants at
20Ncm using the O-Ring/Dal-Ro Driver Tip (RAOR1) in a torque
device. (If the surgeon places the abutments, the patients existing
denture will be relieved to allow for the abutments.)
Restorative Dentist
6. A custom or stock closed impression tray may be used.
Provide relief for the height of the Dal-Ro Abutments plus 2mm.
NOTE: If the impression is to be used to fabricate the
overdenture, a custom impression tray should be made.
7. Syringe impression material around each Dal-Ro Abutment.
Use injection viscosity impression material to inject the material
around the attachments intraorally. Use medium or heavy body
viscosity impression material for the tray.
NOTE: There are no impression copings for Dal-Ro Abutments.
8. Load the impression tray and seat it in the mouth. Allow the
impression material to set per the manufacturers instructions.
103
Tissue Supported Overdenture
Dal-Ro Abutment
Indirect Technique (Contd)
9. Remove the impression from the mouth and verify that the
impression material completely adapted around each abutment.
Relieve the patients existing denture to allow for the Dal-Ro
Abutments. Place a chairside soft liner into the patients existing
denture around the abutments and seat the denture. Have the
patient close into centric occlusion. Allow the soft liner to set per the
manufacturers instructions.
Laboratory
10. Insert the Dal-Ro Laboratory Analogs (DRLAU) into the
impression using rm pressure until the ball portion fully engages
the undercut.
11. Pour the cast in die stone, being careful to not dislodge the
analogs. Fabricate a record base and wax occlusion rim.
Restorative Dentist
12. Place the occlusion rim into the mouth. Make the
interocclusal records.
104
Tissue Supported Overdenture
Dal-Ro Abutment
Indirect Technique (Contd)
Laboratory
13. Articulate the casts using the interocclusal record. Set the
denture teeth on the record base for the wax try-in.
Restorative Dentist
14. Place the wax denture into the mouth. Verify occlusion,
aesthetics and phonetics. Make any adjustments necessary. If
major adjustments are necessary, make a new interocclusal record
and return to the laboratory for a new articulator mounting, wax
denture set-up and try-in.
Laboratory
15. After the wax denture is veried, ask the denture on the
cast. Boil out the wax and separate the ask. Place the Dal-Ro
Spacer Rings over the ball portion of the analogs and conform
to the ridges. Screw the Gold Female Attachments (DRTH) into
the housings using the Female Driver Tool (DRFAT1). Place the
housing/attachment assemblies onto the analogs.
16. Process and nish the denture with the Dal-Ro Housings
in place.
105
Tissue Supported Overdenture
Dal-Ro Abutment
Indirect Technique (Contd)
Restorative Dentist
17. Place the overdenture onto the Dal-Ro Abutments in the
mouth, engaging the attachments. Make any occlusal or tissue
adjustments necessary. Instruct the patient on insertion, removal,
maintenance and oral hygiene of the prosthesis.
18. The Gold Female Attachment (DRTH) retention on the
abutment may be adjusted by tightening the housing for more
retention and loosening for less retention (by using the Female
Attachment Tool). The Gold Females may be replaced using
the same technique.
106
Tissue Supported Overdenture
Dal-Ro Abutment
Direct Technique
Restorative Dentist
1. Follow steps 1-5 on pages 101-102 for Dal-Ro Abutment
selection and placement.
2. A direct chairside processing technique may be used for a
patients existing denture or a new denture by cutting relief and
lingual vent windows in the acrylic resin denture base over the
abutment areas.
3. Cut two small pieces of rubber dam and place a hole in the
center. Place these over the abutments to protect the tissue. Screw
the Gold Female Attachments (DRTH) into the housings using
the Female Driver Tool (DRFAT1). Place the housing/attachment
assemblies onto the Dal-Ro Abutments in the mouth. Block out
the undercuts with wax to prevent acrylic resin from owing under
the housings. Try in the denture over the housings to verify it is fully
seated on the ridge and the housings are not in contact with
the denture.
4. Place autopolymerizing acrylic resin or light cure composite
resin over the Dal-Ro Housings and into relief areas of the denture.
Place the denture into position in the mouth and have the patient
close into centric occlusion. Allow the acrylic resin to set per the
manufacturers instructions.
107
Tissue Supported Overdenture
Dal-Ro Abutment
Direct Technique (Contd)
5. Remove the denture, ll any voids around the housings
and polish. Place the overdenture onto the Dal-Ro Abutments in
the mouth, engaging the attachments. Make any occlusal or tissue
adjustments necessary. Instruct the patient on insertion, removal,
maintenance and oral hygiene of the prosthesis.
6. The Gold Female Attachment (DRTH) retention on the
abutment may be adjusted by tightening the housing for more
retention and loosening for less retention by using the Female
Attachment Tool. The Gold Females may be replaced using the
same technique.
108
Tissue Supported Overdenture
O-Ring Abutment
Indirect Technique
Material:
Abutment: Commercially Pure Titanium
O-Ring: Buna
Housing: Titanium Alloy
Surgeon Or Restorative Dentist
1. Select the proper O-Ring Abutment collar height for each
implant by measuring the height of the healing abutment above the
tissue, not including the domed portion. Subtract the measurement
from the total height of the healing abutment and add 1mm.
2. Remove the healing abutments from the implants, one at a
time, using a .048 Large Hex Driver (PHD02N or PHD03N). To
help prevent accidental swallowing, thread oss through the spinner
on the driver.
3. Place the proper height O-Ring Abutment collar onto the
implant, engaging the hex. Thread the O-Ring Abutment Screw into
the implant by engaging the hex below the ball with the O-Ring/
Dal-Ro Driver (PAD01). Fingertighten the screws.
4. Radiograph the interfaces to verify complete seating of the
abutments on the implants. Place the lm perpendicular to the
interface of the abutment on the implant.
Indications:
Tissue Supported Overdenture Retained by Two to Four Implants (Edentulous Patients)
Overdentures with One or More Implants (Partially Edentulous Patients)
Minimum Interarch Space of 7mm
Maximum Tissue Height of 6mm
Recommended for Parallel Implants (See Castable O-Ring System for Divergent Implants)
850 Grams of Retention
SEATED NOT SEATED
109
5. Torque the O-Ring Abutment Screws into the implants at
20Ncm using the O-Ring/Dal-Ro Driver Tip (RAOR1) in a torque
device. (If the surgeon places the abutments, the patients existing
denture will be relieved to allow for the abutments.)
Restorative Dentist
6. A custom or stock closed top impression tray may be used.
Provide relief in the tray for the height of the O-Ring Abutments,
plus 2mm.
NOTE: If the impression is to be used to fabricate the
overdenture, a custom impression tray should be made.
7. Use injection viscosity impression material to inject the material
around the impression copings intraorally. Use low, medium or heavy
body viscosity impression material for the tray.
NOTE: There are no impression copings for O-Ring Abutments.
8. Load the impression tray and seat it in the mouth. Allow the
impression material to set per the manufacturers instructions.
Tissue Supported Overdenture
O-Ring Abutment
Indirect Technique (Contd)
110
9. Remove the impression from the mouth and verify that the
impression material completely adapted around each abutment.
Relieve the patients existing denture to allow for the Dal-Ro
Abutments. Place a chairside soft liner into the denture around
the abutments and seat the denture. Have the patient close into
centric occlusion. Allow the soft liner to set per the
manufacturers instructions.
Laboratory
10. Insert the O-Ring Laboratory Analogs (ORLAN) into the
impression using rm pressure until the ball portion fully engages
the undercut.
11. Pour the cast in stone, being careful to not dislodge the
analogs. Fabricate a record base and wax occlusion rim.
Restorative Dentist
12. Place the record base and occlusion rim into the mouth.
Make the interocclusal records.
Tissue Supported Overdenture
O-Ring Abutment
Indirect Technique (Contd)
111
Laboratory
13. Articulate casts using the interocclusal record. Set the denture
teeth on the record base for the wax try in appointment.
Restorative Dentist
14. Place the wax denture into the mouth. Verify occlusion,
aesthetics and phonetics. Make any adjustments necessary. If major
adjustments are necessary, make a new interocclusal record and
return to the laboratory for a new articulator mounting, wax set-up
and try in appointment.
Laboratory
15. Flask the denture on the cast. Boil out the wax and separate
the ask. Place the Red Processing O-Rings (OSORED) into the
Housings (OSODH). Place the Housing/O-Ring assemblies onto the
analogs. Block out the undercuts with plaster to prevent acrylic resin
from owing under the Housings.
16. Process and nish the denture with the O-Ring Housings in
place. Remove the Red Processing O-Rings and replace with the
Black O-Rings (OSOBLK) (see step 18).
Tissue Supported Overdenture
O-Ring Abutment
Indirect Technique (Contd)
112
Tissue Supported Overdenture
O-Ring Abutment
Indirect Technique (Contd)
Restorative Dentist
17. Place the overdenture onto the O-Ring Abutments in the
mouth, engaging the attachments. Make any occlusal or tissue
adjustments necessary. Instruct the patient on insertion, removal,
maintenance and oral hygiene of the prosthesis.
18. Normal wear will require that the O-Rings be replaced
periodically. Remove the existing O-Ring from the housing using an
explorer and replace with a new Black O-Ring.
113
Tissue Supported Overdenture
O-Ring Abutment
Direct Technique
Surgeon Or Restorative Dentist
1. Follow steps 1-5 on pages 108-109 for O-Ring Abutment
selection and placement.
2. A direct, chairside processing technique may be used for
a patients existing denture or a new denture by cutting relief and
lingual vent windows in the acrylic resin denture base over the
abutment areas.
3. Cut two small pieces of rubber dam and place a hole in the
center of each. Place these over the abutments to protect the tissue.
Place the Red Processing O-Rings (OSORED) into the Housings
(OSODH). Place the O-Ring Housing assemblies onto the O-Ring
Abutments in the mouth. Block out the undercuts with wax to
prevent acrylic resin from owing under the housings. Try in the
denture over the housings to verify it is fully seated on the ridge and
the housings are not in contact with the denture.
4. Place autopolymerizing acrylic resin or light cure composite
resin over the O-Ring Housings and into the relief areas of the
denture. Place the denture into position in the mouth and have the
patient close into centric occlusion. Allow the acrylic resin to set per
the manufacturers instructions.
114
Tissue Supported Overdenture
O-Ring Abutment
Direct Technique (Contd)
5. Remove the denture, ll any voids around the housings
and polish. Remove the Red Processing O-Rings and replace with
the Black O-Rings (see step 6). Place the overdenture onto the
O-Ring Abutments in the mouth, engaging the attachments. Make
any occlusal or tissue adjustments necessary. Instruct the patient on
insertion, removal, maintenance and oral hygiene of the prosthesis.
6. Normal wear will require that the O-Rings be replaced
periodically. With an explorer, remove the existing O-Ring from the
Housing and replace with a new Black O-Ring.
Instructions For Use:
For detailed information on the specic procedure for the
product you are using, please refer to the individual product
labels or the appropriate manual on the BIOMET 3i Website.
Description:
BIOMET 3i Restorative Products are manufactured from
biocompatible titanium, titanium alloy, gold, gold alloy,
zirconium, vanadium, stainless steel, polyetheretherketone
(PEEK), cobalt chromium alloy, and polyoxymethylene (Delrin).
Please refer to product guidelines for use/Surgical Manual for
additional device information.
Indications For Use:
BIOMET 3i Restorative Products are intended for use as
accessories to endosseous dental implants for placement in the
maxilla and mandible.
Provisional Abutments are intended for use as an accessories
to endosseous dental implants to support a prosthetic device
in a partially or fully edentulous patient. They are intended for
use to support a prosthesis in the mandible or maxilla for up to
180 days during endosseous and gingival healing, and are for
non-occlusal loading of provisional restorations. The prostheses
will either the cement, mechanically or screw-retained to
the abutment system based on individual product design. For
compatibility of BellaTek