This treatment demonstrates the restoration of an atrophic mandible with three 4.5 x 6.0mm Bicon SHORT® Implants and a mandibular telescopic TRINIA® prosthesis. Also shown is the Gothic arch technique, which was used to record the patient’s centric occlusal relation.
TOPICS: Impression TRINIA®
TAGS: Occlusal Registration
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Pre-operative radiograph.
Pre-operative facial view.
Pre-operative right profile view.
Pre-operative left profile view.
Pre-operative occluso-lingual view.
Post-operative radiograph of three 4.5 x 6.0mm Bicon SHORT® Implants.
Five-month post-operative view with a visible black healing plug.
Measurement indicating that the vertical dimension of occlusion (VDO) is overclosed by 3.0mm with the patient's overdenture.
Two yellow 5 Series Standard-Tall Profile Universal Abutment Impression Sleeves seated on their corresponding Universal Abutments, and one green Impression Sleeve seated on a 3.0mm green Impression Post for the recording of an initial occlusal registration.
Occlusal registration material being injected around the Impression Sleeves, which were used to establish the VDO.
Three Impression Sleeves and one Universal Abutment captured within an occlusal registration.
Three green Impression Sleeves captured within a full arch implant-level transfer impression.
Mandibular wax rim with a stylus seated on a stone model for recording a Gothic arch.
Maxillary resin rim with a blackened metal plate seated on a stone model for recording a Gothic arch.
Floss indicating that the midline of the maxillary overdenture is inconsistent with the midline of the face.
Measurement indicating that the VDO has been opened by 3.0mm with the mandibular wax rim.
View of the seated maxillary metal plate and mandibular stylus prior to using random mandibular movements to record a Gothic arch.
View of a Gothic arch drawn on the maxillary metal plate by the mandibular stylus during random movements of the patient's mandible.
Plastic disc being placed onto the plate with its bore centered on the apex of the Gothic arch, which indicates the centric relation of occlusion.
Plastic disc, with its bore centered on the apex of the Gothic arch, being luted with sticky wax to the metal plate.
View of the mandibular stylus positioned in the bore of the plastic disc on the maxillary metal plate.
Occlusal registration material being injected around the maxillary overdenture and mandibular wax rim while the stylus is positioned in the bore of the plastic disc on the metal plate.
Facial view of the occlusal registration assemblage.
View of the occlusal registration assemblage with the mandibular stylus positioned in the bore of the plastic disc on the maxillary metal plate.
Stone model with three green 3.0mm Implant Analogs.
Waxed teeth arrangement with an attached green 3.0mm Impression Post to stabilize the rim during its try-in.
Waxed teeth arrangement with its Impression Post seated in one of the Implant Analogs on the stone model.
Facial view of the waxed teeth arrangement with its Impression Post seated in an implant for stabilization.
Occlusal registration of the waxed teeth arrangement being recorded.
Facial view of the recorded occlusal registration with the waxed teeth arrangement.
Three modified Universal Abutments in a soft tissue model.
Three custom cast chrome-cobalt copings seated on their modified Universal Abutments in a soft tissue model.
Light-cured resin verification jig with three copings, which will be used to confirm the path of insertion and retentiveness of the final prosthesis.
Resin orientation and seating jig seated on three modified Universal Abutments in a soft tissue model.
Ridge-side view of a mandibular telescopic TRINIA® prosthesis prior to the intraoral cementation of the copings into its bores with resin cement.
Occlusal view of a mandibular telescopic TRINIA® prosthesis.
Facial view of a mandibular telescopic TRINIA® prosthesis.
View of three white Healing Abutments seated in their implants.
Healing Abutment being removed from its implant.
Reflected view of three implant sulci.
Vaseline being applied to a bore of the orientation and seating jig to facilitate its removal after the abutments have been seated into their implants.
Abutment being loosely inserted into a Vaseline-lined bore of the orientation and seating jig, which is marked with red ink to indicate its buccal side.
First two abutments being inserted into their implants with the orientation and seating jig.
Standard Seating Tip being used to tap the orientation and seating jig.
Standard Seating Tip being used to tap the first abutment while it is positioned in the orientation and seating jig.
Standard Seating Tip being used to tap the second abutment while it is positioned in the orientation and seating jig.
Crown removal instrument being used to remove the orientation and seating jig from the abutments.
Third abutment being transported to its implant in the Vaseline-lined bore of the orientation and seating jig.
Third abutment being inserted into its implant with the orientation and seating jig.
Standard Seating Tip being used to tap the orientation and seating jig.
Standard Seating Tip being used to tap the third abutment while it is positioned in the orientation and seating jig.
Crown removal instrument being used to remove the orientation and seating jig from the abutments.
Standard Seating Tip being used to definitively seat the first abutment.
Standard Seating Tip being used to definitively seat the second abutment.
Standard Seating Tip being used to definitively seat the third abutment.
View of a yellow SiTec insert within a custom cast chrome-cobalt coping, which will provide the prosthesis with 500 grams of retention. SiTec inserts are interchangeable and range from 0 grams of retention (white inserts) to 800 grams of retention (red inserts).
Vaseline being applied to the first coping to facilitate its removal from the abutment after its intraoral cementation into a bore of the prosthesis.
Standard Seating Tip being used to gently tap the first coping onto its abutment.
Vaseline being applied to the second coping to facilitate its removal from the abutment after its intraoral cementation into a bore of the prosthesis.
Standard Seating Tip being used to gently tap the second coping onto its abutment.
Vaseline being applied to the third coping to facilitate its removal from the abutment after its intraoral cementation into a bore of the prosthesis.
Standard Seating Tip being used to definitively seat the third coping onto its abutment.
View of the three copings seated on their abutments.
Vaseline being applied around the bores of the prosthesis to facilitate the removal of any extraneous resin cement.
Resin cement being applied to the bores of the prosthesis.
Cotton Rolls being used to apply occlusal pressure to the prosthesis during the cementation of the copings into the bores of the prosthesis.
Crown removal instrument being used to remove the prosthesis from the abutments.
Extraneous resin cement being removed from around the cemented copings of the prosthesis.
Vaseline being applied to the copings of the prosthesis to facilitate the patient's initial insertion and removal of the prosthesis.
Facial view of the mandibular telescopic TRINIA® prosthesis.
Right profile view of the mandibular telescopic TRINIA® prosthesis.
Left profile view of the mandibular telescopic TRINIA® prosthesis.
Occlusal view of the prosthesis with blue ink from articulating paper being used to confirm appropriate occlusal contacts.
Post-insertion radiograph of the mandibular telescopic TRINIA® prosthesis with its three 4.5 x 6.0mm Bicon SHORT® Implants.
Two-month post-insertion facial view of the mandibular telescopic TRINIA® prosthesis.
Two-month post-insertion facial view of healthy tissue around the three modified Universal Abutments.
Ridge-side view of the mandibular telescopic TRINIA® prosthesis with three copings cemented into its bores, and with bilateral cantilevers.
Occlusal view of the mandibular telescopic TRINIA® prosthesis.
Facial view of the mandibular telescopic TRINIA® prosthesis.
Patient’s smile.
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