Replacing Three 25-Year-Old O-Ring Abutments with Three Universal Abutments for the Fabrication of a Mandibular TRINIA® Telescopic Full-Arch Prosthesis for a Seventy-Three-Year-Old Patient
This case demonstrates the removal of three 25-year-old O-Ring Abutments, implant-level impression technique, gothic arch tracing, placement of three Universal Abutments, cementation of retentive copings, and the insertion of a TRINIA® telescopic full-arch prosthesis on three mandibular implants for a seventy-three-year-old female patient.
Additionally, note the complete compatibly and interchangeability of Bicon components manufactured over two decades ago as well as the healthy mucosa and bone levels around twenty-four-year-old implants.
Below is the patient’s unedited and unscripted comments upon receiving her new prosthesis:
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Pre-operative smile after the removal of existing 25-year-old denture.
2.
Pre-operative radiograph showing 25-year-old O-Ring Abutments on three implants.
3.
View of three 25-year-old mandibular O-Ring Abutments after the removal of existing denture.
4.
O-Ring Abutment being removed with forceps.
5.
Clinical view of three implant sulci.
6.
View of three violet 2.0mm titanium impression posts with their corresponding plastic sleeves.
7.
Impression material being injected around the impression sleeves for the making of a full-arch implant-level transfer impression.
8.
Violet 2.0mm titanium impression post being inserted into its corresponding plastic sleeve within the transfer impression.
9.
Wax rim being used to confirm midline and vertical dimension of occlusion (VDO).
10.
Wax rim being used to confirm midline and vertical dimension of occlusion (VDO).
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Gothic Arch tracing on metal plate.
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Facial view of completed TRINIA® telescopic prosthesis on model.
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TRINIA® telescopic prosthesis on model with three Retentive Copings on Universal Abutments.
14.
Resin seating jig with numerals indicating seating sequence of the Universal Abutments.
15.
O-Ring Abutments prior to being removed.
16.
O-Ring Abutment being removed.
17.
View of seating jig with Vaseline-lined bores.
18.
Universal Abutment being seated in the Vaseline-lined bore of seating jig.
19.
Two first-sequenced abutments are being transported to their implant wells.
20.
Seating jig is being tapped with an abutment seating tip on a straight driver to seat both abutments simultaneously.
21.
Crown removal instrument is being used to tap the Vaseline-lined seating jig from the first two seated abutments.
22.
Second-sequenced abutment is being inserted into the well of its implant.
23.
Seating jig is being tapped to engage second- sequenced abutment into well of its implant.
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Seating jig being removed.
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Universal Abutments being definitively tapped.
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TRINIA® telescopic prosthesis being placed onto the abutments to confirm its passive fit.
27.
Black marks indicating non-passive fit prior to being removed.
28.
Black marks being removed with a finishing bur.
29.
Vaseline being applied to the bores of the retentive copings to facilitate the removal of the prosthesis when the copings are cemented into its bores.
30.
Vaseline-lined retentive copings being placed onto Universal Abutments.
31.
Vaseline-lined retentive copings being definitively seated onto the Universal Abutments with a gentle tap.
32.
Third retentive coping being placed onto Universal Abutment.
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Third Vaseline-lined retentive coping being definitively seated.
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Retentive copings definitively seated on Universal Abutments.
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TRINIA® telescopic prosthesis being placed onto the retentive copings to confirm its passive fit.
36.
Black marks being removed with a finishing bur.
37.
Vaseline being applied to facilitate removal of extraneous cement.
38.
Minimal cement being applied to the bores of the TRINIA® prosthesis.
39.
TRINIA® prosthesis being cemented onto the retentive copings.
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Occlusal pressure being applied for the cementation of the retentive copings into the TRINIA® prosthesis.
41.
Extraneous cement prior to being removed from Universal Abutments.
42.
Universal Abutments after removal of extraneous cement. Note the preferred positioning of the abutment shoulders above the mucosa, which facilitates both seating and maintenance.
43.
View of three retentive copings after being permanently cemented into the bores of the TRINIA® prosthesis.
44.
23.37mm cantilever of mandibular prosthesis being measured.
45.
View of seated TRINIA® prosthesis. Note the preferred positioning of the abutment shoulders above the mucosa, which facilitates both seating and maintenance.
46.
Red ink markings indicating initial occlusal contacts.
47.
View of final seated TRINIA® prosthesis.
48.
Patient’s pre-operative smile.
49.
Patient's smile after the insertion of the telescopic full-arch TRINIA® prosthesis.
50.
Post-operative radiograph showing new telescopic full-arch TRINIA® prosthesis on three 25-year-old implants.
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