This case demonstrates the clinical and laboratory procedures for the fabrication of maxillary and mandibular full-arch telescopic TRINIA™ restorations, each using four Bicon SHORT® Implants and cast chrome cobalt copings with Si-tec TK-FRIC retentive attachments in only three clinical visits.
RESTORATIVE: Telescopic Restorations
TOPICS: TRINIA®
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Pre-operative radiograph.
Radiograph of mandibular implants.
Radiograph of maxillary implants.
FIRST CLINICAL VISIT: Eight color-coded metal impression posts.
Four color-coded acrylic impression sleeves on metal impression posts.
Full-arch implant-level transfer impression being made.
Maxillary impression with four acrylic sleeves within.
Green 3.0mm impression post attached to a 3.0mm implant analog.
Assembled impression post and implant analog being inserted into the acrylic sleeve within the mandibular implant-level transfer impression.
Maxillary impression being sprayed with a universal separator.
Soft tissue moulage being applied around the implant analogs to simulate the mucosa.
Dental stone being poured around the implant analogs and soft tissue moulage.
Articulated models with bite registration material over impression posts.
Articulated models with impression posts.
Universal abutment being inserted into corresponding implant analog.
Universal abutments being modified to achieve parallelism.
Light-cured resin jig being fabricated to facilitate the insertion of parallel abutments into implant analogs within the model, and intraorally into the implants.
Articulated model and light-cured resin jig with sequential markings to facilitate the insertion of the abutments.
Articulated waxed teeth arrangement.
Teeth arrangement in group function.
SECOND CLINICAL VISIT: Light-cured resin jig being used to facilitate the sequencing and actual orientation and seating of the milled abutments.
Four seated parallel abutments.
Waxed teeth arrangments being confirmed intraorally.
Intraoral confirmation of waxed teeth arrangements.
Maxillary silicone mask of confirmed waxed teeth arrangements.
Fabricated mandibular silicone mask of confirmed waxed teeth arrangement.
Three types of wax are used to fabricate telescopic copings: soft wax by Yeti, medium violet wax by GC, and hard green wax by Renfert.
Maxillary waxed telescopic copings.
Waxed mandibular copings with retentive attachments.
Ghero Si-tec TK-FRIC retentive attachment to wax coping.
Invested maxillary waxed copings.
Mandibular copings being invested.
Chrome cobalt-casted telescopic copings with Ghero Si-tec TK-FRIC retentive attachments.
Digital image of scanned telescopic copings adapted on abutments.
Digital image of scanned light-cured resin bar over telescopic copings.
Digital image of scanned bar.
Digital image of scanned bar with copings.
Designed digital bar with red connectors indicating attachments to the TRINIA™ disc.
Substructure being milled from the TRINIA™ disc.
Milled substructure within the TRINIA™ disc.
TRINIA™ bar adapted over telescopic copings on a model.
Position of teeth arrangement was established with previously fabricated silicone mask, and attached to TRINIA™ bar with wax.
Teeth arrangement after wax was removed from cervical area around the Candulor teeth.
Second silicone mask being fabricated to reflect new gingival contours.
Wax was removed with a steam spray to clean TRINIA™ bar and Candulor teeth.
Cyanoacrylate glue being used to attach the Candulor teeth to the violet-colored silicone mask.
Pink TRINIA™ bar, Candulor teeth, and violet-colored silicone mask revealing minimal space for adding acrylic resin to bond the teeth to the bar.
Shofu CRB 1 and CRB 2 being applied to bond the acrylic resin to the TRINIA™ bar.
Acrylic resin used to bond the Candulor teeth to the TRINIA™ bar.
THIRD CLINICAL VISIT: Vaseline being applied to the bore of a telescopic coping to facilitate its withdrawal from a mandibular milled abutment.
Cast chrome cobalt telescopic coping being placed onto a mandibular milled abutment.
Four seated cast chrome cobalt telescopic copings seated on parallel abutments.
Resin cement being applied to the bores of the mandibular TRINIA™ prosthesis.
Vaseline being applied to the bore of a maxillary telescopic coping to facilitate its withdrawal from a maxillary abutment.
Cast chrome cobalt telescopic coping being placed onto a milled abutment.
Resin cement being applied to the bores of the maxillary TRINIA™ prosthesis.
Radiographic image of the mandibular implants and the telescopic TRINIA™ prosthesis.
Clinical image of the two full-arch telescopic TRINIA™ prostheses.
Patient's smile with two full-arch telescopic TRINIA prostheses.
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