This case demonstrates the placement of two 4.0 x 6.0mm and two 4.0 x 8.0mm Standard Profile Fixed-Detachable Universal Abutment Transitional Implants using guided surgery and their immediate loading with a mandibular full-arch screw-retained TRINIA® prosthesis with cemented copings within the bores of the TRINIA® prosthesis, subsequent to the placement of four Bicon SHORT® Implants also using guided surgery for their 2.0mm pilot osteotomies.
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2.0mm Pilot Drill being inserted into bore of surgical guide.
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2.0mm Pilot Drill preparing osteotomy through surgical guide.
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Crestal incision being made to expose pilot osteotomy.
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2.0mm Pilot Drill being used to achieve final depth of osteotomy
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Hand Reamer attached to Threaded Instrument Adapter being used to widen pilot osteotomy to a diameter of 2.5mm.
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Hand Reamer attached to Threaded Instrument Adapter being used to widen pilot osteotomy to a diameter of 3.0mm.
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Hand Reamer attached to Threaded Instrument Adapter being used to widen pilot osteotomy to a diameter of 3.5mm.
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Hand Reamer attached to Threaded Instrument Adapter being used to widen pilot osteotomy to a diameter of 4.0mm.
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Hand Reamer attached to Threaded Instrument Adapter being used to widen pilot osteotomy to a diameter of 4.5mm.
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Residual bone chips are being removed from the osteotomy with a spoon excavator, while confirming the integrity of the five walls of the osteotomy.
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A 4.5 x 6.0mm Bicon SHORT® Implant attached to a black Healing Plug is being inserted into the osteotomy.
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View of initially seated implant with a 3.0mm well.
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Implant is being definitively seated with a gentle tap with a 3.0mm Seating Tip attached to an Offset Driver.
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Cut Healing Plug being transported into implant well with a Healing Plug Removal Instrument.
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View of cut Healing Plug prior to being covered with harvested bone.
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Harvested bone is being placed over seated implant, prior to removal of retraction suture and flap closure.
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View of surgical site after placement of four Bicon SHORT® Implants and prior to placement of four Fixed-Detachable Universal Abutment Transitional Implants.
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Components used in this case: Hex Screwdriver, Hex Retention Screws, Retentive Copings, Latch Transitional Driver, and 4.0 x 6.0mm and a 4.0 x 8.0mm Standard Profile Fixed-Detachable Universal Abutment Transitional Implants.
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Pilot osteotomy being prepared through surgical guide with a 2.0mm Pilot Drill for one of four 2.5mm Fixed-Detachable Universal Abutment Transitional Implants.
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Another 2.0mm pilot osteotomy is being prepared for 2.5mm Fixed-Detachable Universal Abutment Transitional Implant.
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Another 2.0mm pilot osteotomy is being prepared for 2.5mm Fixed-Detachable Universal Abutment Transitional Implant.
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Four 2.0mm Guide Pins indicating trajectory of 2.0mm pilot osteotomies.
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TRINIA® prosthesis being placed over the Guide Pins to confirm appropriateness of the bores within TRINIA® prosthesis.
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A 4.0 x 6.0mm Standard Profile 0° Fixed-Detachable Universal Abutment Transitional Implant is being transported to its 2.0mm wide osteotomy with a Transitional Implant Driver.
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Transitional Implant Driver being used to rotate the 2.5mm wide Transitional Implant into its 2.0mm wide osteotomy.
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Transitional Implant Driver being used with apical pressure to assure that the hemispherical base of Transitional Implant is firmly seated on bone.
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View of a 4.0 X 6.0mm Standard Profile 0° Fixed-Detachable Universal Abutment Transitional Implant appropriately positioned on alveolar ridge.
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A 2.5mm wide 4.0 X 8.0mm Standard Profile 0° Fixed-Detachable Universal Abutment Transitional Implant is rotated into its 2.0mm osteotomy with a Transitional Implant Driver with apical pressure.
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Transitional Implant is almost fully seated on bone by the apical pressure being applied to the rotating Transitional Driver.
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Fixed-Detachable Coping being transported with a retentive screw attached to Hex Screw Driver to the seated Fixed-Detachable Universal Abutment Transitional Implant.
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Fixed-Detachable Coping being fastened to the Transitional Implant with a Hex Retentive Screw with a Hex Driver.
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TRINIA® prosthesis is being placed onto the four copings attached to Transitional Implants to confirm a passive path of insertion.
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TRINIA® prosthesis after being modified to fit over the copings is being reinserted to confirm a passive path of insertion.
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Resin cement is being applied to a bore of TRINIA® prosthesis prior to being inserted onto the copings to mechanically attach them to the TRINIA® prosthesis.
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Hex retentive Screw being removed from the Transitional Implant after the mechanical attachment of the Coping to the TRINIA® prosthesis.
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Occlusal view of TRINIA® prosthesis after it was unfastened from the four Transitional Implants.
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View of TRINIA® prosthesis with four Copings attached with resin cement.
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TRINIA® prosthesis being fastened to Transitional Implant with a Hex Retentive Screw.
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TRINIA® prosthesis being fastened to Transitional Implant with a Hex Retentive Screw.
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TRINIA® prosthesis being fastened to Transitional Implant with a Hex Retentive Screw.
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TRINIA® prosthesis being fastened to Transitional Implant with a Hex Retentive Screw.
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Panoramic radiograph revealing a TRINIA® prosthesis with four Transitional Implants of which two are fastened with a Coping and Hex Retentive screw.
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Clinical appearance at beginning of ten day post- operative visit.
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View of four Standard Profile Fixed- Detachable Universal Abutment Transitional Implants after removal of TRINIA® prosthesis during ten day post-operative visit.
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Flowable composite being applied over cotton covering retention screw after the re-insertion and fastening of TRINIA® prosthesis.
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Periapical radiograph of one Bicon SHORT® Implant and two Transitional Implants fastened with retentive screws through copings mechanically attached to TRINIA® prosthesis.
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Periapical radiograph of two Bicon SHORT® Implant and two Transitional Implants fastened with retentive screws through copings mechanically attached to TRINIA® prosthesis.
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Patient's smile after ten day post-operative visit.
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