This case demonstrates the insertion of angled fixed detachable abutments on three nonparallel implants and the making of an abutment level transfer impression as well as the design and fabrication of a Dolder bar overdenture with CAD/CAM technology.
RESTORATIVE: Overdentures
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Radiograph of three non-parallel implants with no abutment, one 15Ë angled o-ring abutment, and one 0Ë angled abutment prior to replacement with three 15Ë angled fixed-detachable abutments.
View of 15° angled fixed detachable abutment with 10mm hex coping screw.
View of 15° angled fixed detachable abutment with 10mm hex coping screw being seated into the well of implant.
Paralleling of abutments is easily achieved with the use of two 15° angled fixed detachable abutments that have the possibility of 360° of universal positioning.
Implant seating tip attached to a straight handle being used to tap the 15° angled fixed abutment into the well of the implant.
Hex screwdriver being used to remove hex coping screw from the angled fixed detachable abutment.
Parallelism of abutments was easily achieved with the use of three 15° angled fixed detachable abutments after abutment had been definitively seated by tapping into the implant well.
Radiograph of three non parallel implants with three 15° angled abutments and one 0° angled abutment for screw retained restorations.
Metal impression coping being inserted onto 15° angled fixed detachable abutment.
A 10.0mm hex coping screw is being inserted to retain a metal impression coping.
Metal impression coping is being inserted onto 15° angled fixed detachable abutment.
A 10.0mm hex coping screw being inserted to retain the metal impression coping.
Metal impression coping is being inserted onto angled fixed detachable abutment.
10.0mm hex coping screw being placed to fashion impression coping.
Hex screw driver being used to fasten 10.0 mm hex coping screw.
View of three parallel impression copings with hex coping screws.
Cotton pellet being inserted into the hole of the hex coping screw to prevent impression material from flowing into the holes.
Red resin being used to fabricate a jig to secure the positioning of the impression copings relative to one another.
View of red resin jig around impression copings.
Impression material being injected around impression copings and resin jig for the making of a full arch abutment level transfer impression.
Hex coping screw being unfastened through the open tray to allow for the pickup of the metal impression copings within the impression.
Hex coping screw being removed.
View of impression with three metal impression copings.
Brass abutment analog being inserted into metal impression coping within the impression.
Brass abutment analog being inserted into metal impression coping within the impression.
View of impression with three brass abutment analogs screwed into the metal impression copings.
Debubblizer (Smoothex) being applied to the impression to reduce the possibility of bubbles in the cast.
Impression being poured to fabricate a stone model.
View of wax rim on the stone model.
Registration material being injected onto wax rim.
Recording the occlusal registration.
Wax rim and denture being removed.
View of denture wax set-up on the stone model.
CAD-CAM view of the denture wax set-up and Dolder bar on the stone model.
Frontal view of overdenture bar being designed.
Left profile view of the denture wax set-up and Dolder bar on the stone model.
Left profile view of the designed overdenture bar.
Right profile view of the denture wax set-up and Dolder bar on the stone model.
Right profile view of the designed overdenture bar.
Occlusal view of the denture wax set-up and Dolder bar on the stone model.
Occlusal view of the designed overdenture bar.
CAD- CAM milled overdenture bar on the stone model with four retentive Dolder clips.
Wax being placed around the Dolder bar to avoid undercuts during the making of impression.
Wax covering milled bar and Dolder clips prior to laboratory impression.
Full arch laboratory impression.
Impression being poured with the dental stone.
View of the stone model prior to placement of wax denture set-up.
A thin mix of stone is painted directly on the acrylic teeth to form an accurate matrix for wax set-up and prevention of tooth movement.
The flash cover is seated against the soft plaster prior to boiling the wax.
Cast in the flask after the wax has been boiled away.
Acrylic being packed into the flask.
Excess acrylic being forced out by the flask press.
Two pieces of floss have been placed on the milled bar to prepare for its removal and separation from the bar.
Denture with Dolder clips being seated onto Dolder bar without fastening screws in the bar.
The denture being picked up with Dolder bar and clips attached.
Acrylic being applied around the clips to stabilize Dolder clips inside denture.
Milled bar is being fastened with screws prior to confirming the appropriate fit of the denture.
Denture on stone model.
Radiograph of three non-parallel implants with milled overdenture bar attached.
View of denture with four retentive Dolder clips inside.
Denture being inserted.
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