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