Nine-Year Follow-Up and CBCT Imaging of 24 Bicon SHORT® Implants and Integrated Abutment Crowns™ (IACs)

Posted on February 24, 2018 in Integrated Abutment Crowns™, Restorative, SHORT® Implants

This case demonstrates the nine-year follow-up, cone beam computed tomography (CBCT) imaging, and intraoral polishing of twenty-four Bicon SHORT® Implants and their individual Integrated Abutment Crowns™ (IACs). The documentation of the surgical and restorative treatments can be found at the following link: http://bit.ly/2orgcxl

One-Stage Surgical Placement of Two Maxillary and One Mandibular Congenitally Missing Lateral Incisors with SHORT® Implants

Posted on February 23, 2018 in Integrated Abutment Crowns™, One Stage, Restorative, SHORT® Implants, Surgical

This treatment demonstrates the Bicon one-stage surgical technique with transmucosal Temporary Abutments for three congenitally missing lateral incisors in a 21-year-old man and their subsequent prosthetic restoration with three Integrated Abutment Crowns™(IACs).

Insertion and Adjustment of an Eight-Unit Maxillary Telescopic TRINIA® Prosthesis on Four SHORT® Implants

Posted on February 2, 2018 in SHORT® Implants

This treatment demonstrates the clinical techniques for the fabrication and insertion of an eight-unit maxillary telescopic TRINIA® prosthesis on three custom cast chrome cobalt telescopic copings and one milled retentive coping, and the subsequent removal (three weeks later) of excessive polyceramic material from around the margins to eliminate irritation to the soft tissues under the prosthesis. This treatment also demonstrates the clinical compromises to healthy soft tissues caused by trying to achieve unnecessary gingival aesthetics rather than accepting supragingival titanium abutment margins.

Implant Placement and Restoration of a Six-Unit Cemented TRINIA® Prosthesis in Only Two Clinical Visits

Posted on January 18, 2018 in Extraction, Immediate Placement, SHORT® Implants

This treatment demonstrates the extraction of a maxillary lateral incisor and the immediate placement of a 4.0 x 6.0-mm implant with a 2.5-mm well for a 91-year-old man. An implant-level transfer impression was made for an existing integrated molar implant and the immediately placed incisor implant. The existing molar implant, with a 3.0-mm well, was used to provide support for a temporary prosthesis during the four months of healing. The permanent TRINIA® prosthesis with six units of handcrafted polyceramic teeth was cemented at the time of the implant’s uncovering during the patient’s second clinical visit.

Replacement of a Failed Screw-Retained Prosthesis with a Telescopic TRIO-TRINIA® Prosthesis with Milled Hybrid Polyceramic Teeth

Posted on December 27, 2017 in Restorative, SHORT® Implants, Surgical, Telescopic Restorations, Uncovering

This treatment for an 83-year-old woman, who presented with a failed maxillary prosthesis supported by five screw-retained IMZ implants, demonstrates the clinical capabilities of a telescopic TRINIA® prosthesis supported by only three Bicon SHORT® Implants: two 4.5 x 6.0-mm implants with a 3.0-mm well, and one 4.0 x 6.0-mm implant with a 2.5-mm well. The laboratory techniques and procedures of this treatment are also presented. After five months of healing, the implants were uncovered and a telescopic TRIO-TRINIA® prosthesis was fabricated with milled hybrid polyceramic teeth.

Immediate Load of Three Maxillary Incisor 4.5 x 8.0mm Implants

Posted on December 13, 2017 in Immediate Placement, Integrated Abutment Crowns™, Restorative, Surgical

This treatment demonstrates the extraction of teeth #8, 9, and 10, and the subsequent placement and immediate loading of three 4.5 x 8.0mm implants with 2.5mm wells, the preparation of the osteotomy with latch reamers rotating at 50RPM, as well as the fabrication of a temporary stabilizing prosthesis with polyacrylate material and a vacupress former.

Anterior Placement of Two 3.0 x 6.0mm SHORT® Implants with Mandibular Central Incisor Integrated Abutment Crowns™

Posted on December 11, 2017 in Integrated Abutment Crowns™, Restorative, SHORT® Implants, Uncovering

This treatment demonstrates the placement of two 3.0 x 6.0mm SHORT® Implants with 2.0mm wells and the insertion of two mandibular central incisor Integrated Abutment Crowns™ (IACs).

Placement of Two 4.0 x 6.0mm SHORT® Implants in the areas of Congenitally Missing Maxillary Lateral Incisors with Grafting Procedures

Posted on December 11, 2017 in Integrated Abutment Crowns™, Restorative, SHORT® Implants

This treatment demonstrates the placement of two 4.0 x 6.0mm SHORT® Implants for the replacement of congenitally missing maxillary lateral incisors using harvested autogenous bone, SynthoGraft™ (a pure phase beta-tricalcium phosphate), collagen membranes, and leukocyte platelet-rich fibrin (LPRF) membranes.

Replacement of an O-ring Mandibular Overdenture with a Telescopic TRINIA®-HC Prosthesis Utilizing Gothic Arch Occlusal Registration Tracing

Posted on October 30, 2017 in Overdentures

This case demonstrates the clinical and laboratory procedures and techniques to replace a 10-year-old O-Ring mandibular overdenture on three O-Ring Abutments with a telescopic prosthesis of TRINIA® and Shofu disc HC, CAD/CAM material, with three milled retentive copings on Universal Abutments in two clinical visits for a 75-year-old woman.

During the first clinical visit, the three O-Ring Abutments were removed from their implants, and three 2.0mm impression posts and corresponding acrylic sleeves were inserted for the making of a full arch implant-level transfer impression. An initial centric occlusal registration was recorded using modified acrylic impression sleeves at the patient’s existing vertical dimension of occlusion with the bite registration material, Capture. While the patient waited, the impressions were poured and the stone models articulated for the fabrication of a maxillary stylus and mandibular tracing plate to facilitate the registration of the patient’s centric relation utilizing the Gothic arch occlusal registration tracing. After recording the patient’s centric relation, the O-Ring Abutments were re-inserted, and the occlusal registration was sent to the dental technician for the fabrication of a telescopic TRINIA® substructure to which three separately milled teeth arrangements of Shofu disc HC material were bonded.

During the second clinical visit, the O-Ring Abutments were removed, and three Universal Abutments were inserted into the implants utilizing a light-cured resin orientation/seating jig, prior to the cementation of three milled retentive copings into the bores of the TRINIA®-HC prosthesis.

Laboratory and Clinical Aspects of Fabricating and Inserting Eleven Universal Abutments for an Immediate Insertion of Two Milled PMMA Transitional Prostheses, and the Subsequent Insertion of Two Permanent Telescopic Prostheses with Handcrafted Polyceramic Teeth on TRINIA® Frameworks with Eight Milled Copings and One Custom Cast Chrome Cobalt Coping with an Interchangeable Retentive Attachment

Posted on October 23, 2017 in Uncategorized

This presentation depicts the detailed techniques, aspects, and nuances of the laboratory procedures as well as the clinical treatments during the second and third restorative visits for the insertion of PMMA and TRINIA® prostheses. It also shows the increased difficulties and extended clinical time associated with placing more than four implants to support a TRINIA® telescopic prosthesis. A brief outline of the treatment steps is described below:

During the first restorative visit (not shown) and laboratory visit: the surgical uncovering of eleven implants, the fabrication of two implant-level transfer impressions, the recording of an initial occlusal relationship, and the selection of an aesthetic tooth shade. After this restorative visit, the impressions were sent to the laboratory for the fabrication of soft tissue master models; teeth arrangements; digital scans of teeth arrangements; modified and unmodified Universal Abutments; and PMMA (polymethyl methacralate) transitional prostheses.

During the second visit: the extraction of the four mandibular teeth; the insertion of eight unmodified and three modified Universal Abutments; the try-in of two waxed denture teeth arrangements on resin bases to confirm the appropriateness of the teeth arrangements, as well as the insertion of two milled PMMA full arch transitional prostheses (with gingiva-colored Ceramage material added for aesthetics) to function while the permanent TRINIA® restorations were being fabricated. The modified abutments were necessary to compensate for the less than ideal positioning of two maxillary implants and one mandibular implant. The modified mandibular abutment required the use of a custom cast chrome cobalt retentive coping.

During the third visit: The insertion of two handcrafted polyceramic teeth restorations on telescopic TRINIA® frameworks with eight cemented milled retentive copings and one custom cast chrome cobalt coping with a yellow Sci Tec retentive attachment, which provides 500 grams of retention. Two modified Universal Abutments were not used with telescopic copings, since there was sufficient retention with the four retentive copings, indicative of the fact that using more than four implants does not necessarily improve the clinical retention. Using more than four implants will provide some convenience, if an implant were to fail; however, using more than four implants increases the prosthetic complexity of the restoration.