Fabrication of a Maxillary Telescopic TRINIA® Prosthesis and a Mandibular TRINIA® Overdenture and the Subsequent Conversion of the Mandibular Brevis™ O-Ring Overdenture to a Telescopic Prosthesis After One Year in Function
This treatment of a seventy-five-year-old woman, who was previously told by six clinicians that dental implants would be an impossible treatment option (despite the fact that one clinician augmented her right maxilla with graft material), clearly demonstrates the unmatched clinical capabilities of Bicon SHORT® Implants and TRINIA® metal-free CAD/CAM material. The surgical placement of two maxillary and two mandibular implants is also shown, as well as the initial prosthetic restoration of a maxillary telescopic prosthesis and a mandibular Brevis™ O-Ring-retained mandibular overdenture, and the clinical and laboratory techniques for modifying and converting the mandibular Brevis™ O-Ring overdenture to a full-arch telescopic TRINIA® prosthesis after one year in function.
Please view the video below for the laboratory demonstration:
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Pre-operative radiograph revealing bone graft in the maxillary right arch.
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Reflected full-thickness flap revealing two markings prepared with a Hand Reamer.
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Two osteotomies prepared with a Hand Reamer and Mallet prior to placing SynthoGraft™ for an internal sinus lift procedure.
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5.0 x 6.0mm Bicon SHORT® Implant with a 3.0mm well attached to a 6.0mm Sinus Lift Abutment being inserted with a violet 2.0mm Implant Inserter/Retriever.
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SynthoGraft™ being applied under and around the Sinus Lift Abutments.
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Post-operative radiograph.
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Clinical view prior to the uncovering of the two maxillary right implants.
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View of two Sinus Lift Abutments after six months of healing.
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Sinus Lift Abutment being removed with Abutment Removal Forceps.
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View of implants after removal of the Sinus Lift Abutments.
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Sutured site with two titanium 5.0mm Temporary Abutments.
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View of one blue 2.5mm and three green 3.0mm titanium Impression Posts with their corresponding Impression Sleeves.
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Patient's smile with a wax rim being used to record her midline and smile line.
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Wax rim with patient's midline and smile line recorded.
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Maxillary waxed teeth arrangement.
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Mandibular waxed teeth arrangement.
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Waxed teeth arrangements being evaluated for aesthetics and function.
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Waxed teeth arrangements being evaluated for aesthetics and function.
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Master model with one passive and three retentive Universal Abutment Copings.
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Verification jig with one passive and three retentive Universal Abutment Copings to confirm the retentiveness and path of insertion of the intended prosthesis.
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Master model with a light-cured orientation and seating jig relined with pattern resin.
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Intraoral view of a light-cured orientation and seating jig relined with pattern resin.
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Occlusal view of four 5 Series Universal Abutments. Note the divergence of the abutments, which provides the retentiveness for the prosthesis.
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Clinical confirmation of the maxillary and mandibular TRINIA® frameworks with waxed teeth arrangements.
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Occlusal registration of the waxed teeth arrangements.
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Occlusal registration of the waxed teeth arrangements.
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Maxillary telescopic TRINIA® restoration.
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Mandibular Brevis™ O-Ring TRINIA® overdenture with flanges.
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Retentive Universal Abutment coping being seated onto a 5 Series Universal Abutment.
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Four retentive Universal Abutment Copings seated on their 5 Series Universal Abutments.
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Vaseline being applied to the surface of the ridge side of the TRINIA® prosthesis to facilitate the removal of extraneous resin cement.
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Resin cement being applied to the bores of the TRINIA® prosthesis.
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View of the maxillary TRINIA® prosthesis with extraneous resin cement during its cementation to four Universal Abutment Copings.
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Ridge-side view of the maxillary TRINIA® prosthesis with four cemented Universal Abutment Copings.
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Extraneous resin cement being removed from the ridge side of the maxillary TRINIA® prosthesis.
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Resin cement being applied to the bores of the mandibular TRINIA® overdenture for the cementation of two Brevis™ O-Ring Housings.
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View of the mandibular TRINIA® overdenture with extraneous resin cement during its cementation to two Brevis™ O-Ring Housings.
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Ridge-side view of the mandibular TRINIA® overdenture with two Brevis™ O-Ring Housings and flanges.
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Facial view of the maxillary telescopic TRINIA® prosthesis and the mandibular TRINIA® overdenture with two Brevis™ O-Ring Housings and flanges.
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Patient's smile with the maxillary telescopic TRINIA® prosthesis and the mandibular Brevis™ O-Ring TRINIA® overdenture.
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Post-insertion radiograph of the maxillary telescopic TRINIA® prosthesis and the mandibular TRINIA® overdenture with two Brevis™ O-Ring Housings and flanges.
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One-year post-insertion maxillary clinical view.
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Blue 3.5mm Latch Reamer being used to widen the osteotomy for an additional implant to be placed next to a Brevis™ Abutment.
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Violet 4.0mm Latch Reamer being used to widen the osteotomy for an additional implant to be placed next to a Brevis™ Abutment.
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Additional implant being placed next to a Brevis™ Abutment with a black polyethylene Healing Plug Inserter.
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Additional implant being placed next to a Brevis™ Abutment with a Healing Plug Inserter, which is being tapped with a blue 2.5mm Seating Tip attached to a Threaded Straight Handle.
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Mandibular clinical view after the insertion of a Universal Abutment and a Temporary Abutment with two existing Brevis™ Abutments.
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View of four blue 2.5mm titanium Impression Posts with their corresponding Impression Sleeves. See the video above for the laboratory conversion of the TRINIA® overdenture to a telescopic prosthesis.
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First-sequenced 5 Series Universal Abutment being seated with a numerically marked orientation and seating jig and a Threaded Offset Handle.
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Second-sequenced 5 Series Universal Abutment being seated with a numerically marked orientation and seating jig and a Threaded Offset Handle.
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Facial view of four 5 Series Universal Abutments.
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Facial view of four vertically reduced retentive Universal Abutment Copings.
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Verification paste being used to adjust premature contacts of the TRINIA® prosthesis.
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High-speed bur being used to adjust premature contacts of the TRINIA® prosthesis.
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Bonding agent being applied to the bores of the TRINIA® prosthesis.
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Bonding agent being light-cured to the bores of the TRINIA® prosthesis.
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Resin cement being applied to the bores of the Vaseline-lined converted telescopic TRINIA® prosthesis.
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Ridge-side view of the converted mandibular telescopic TRINIA® prosthesis with four cemented Universal Abutment Copings prior to the removal of the extraneous cement.
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Extraneous resin cement being removed from the ridge side of the converted mandibular telescopic TRINIA® prosthesis.
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Ridge-side view of the converted mandibular telescopic TRINIA® prosthesis with four cemented Universal Abutment Copings.
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Maxillary clinical view of four 5 Series Universal Abutments.
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Mandibular clinical view of four 5 Series Universal Abutments.
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Two-year facial view of a maxillary telescopic TRINIA® prosthesis and a recently converted mandibular telescopic TRINIA® prosthesis.
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Two-year post-insertion radiograph of six implants, six-month post-insertion radiograph of two mandibular posterior implants, and two telescopic TRINIA® prostheses. The mandibular prosthesis was recently converted from a tissue-supported Brevis™ O-Ring overdenture to a telescopic implant-supported prosthesis.
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