Fabricating and Inserting a Maxillary and a Mandibular Telescopic TRINIA® Prosthesis with Universal Abutment Copings on Bicon SHORT® Implants

Clinical techniques for fabricating and inserting a maxillary and a mandibular telescopic trinia prosthesis with universal abutment copings on Bicon short implants. Preoperative and postoperative radiographs. Preoperative radiograph. Postoperative radiograph of four 4.5 x 8.0mm and four 5.0 x 6.0mm Bicon short implants. Five month postoperative radiograph of eight Bicon short implants. A 5 series sulcus former attached to a threaded straight handle being rotated to remove any tissue which may prevent the seating of the five series universal abutment. Removal of temporary abutments. Inserting two blue 2.5mm and two green 3.0mm titanium impression posts in their respective implants, definitively seating two blue 2.5mm and two green 3.0mm titanium impression posts in their respective implants with a gentle tap. Impression posts seated in their respective implants for the making of a full arch implant level transfer impression, color coded acrylic impression sleeves being snapped onto their corresponding impression posts, impression material being injected around the impression posts, and their corresponding acrylic impression sleeves, maxillary full arch implant level transfer impression, impression posts seated in their respective implants for the making of a full arch implant level transfer impression, impression material being injected around the impression posts, and their corresponding acrylic impression sleeves. Mandibular full arch implant level transfer impression. Recording of vertical dimension of occlusion, (VDO) and occlusal registration. Vertical dimension of occlusion being recorded. Midline being denoted with dental floss while the occlusal registration is being recorded. Impression sleeves captured within the maxillary side of occlusal registration material. Impression sleeves captured within the mandibular side of occlusal registration material. Stone model being poured around two blue and two green implant analogs seated in the maxillary full arch implant level transfer impression, maxillary and mandibular wax teeth arrangements seated on their stone models, four titanium temporary abutments seated in their maxillary implants, four maxillary implant sulci, Impression post with an implant being used to stabilize the waxed teeth arrangement. Four, titanium temporary abutments seated in their mandibular implants. Four mandibular implant sulci. Impression post with an implant being used to stabilize the waxed teeth arrangement. Occlusal registration being recorded with the maxillary and mandibular waxed teeth arrangements. Lab fabrication of verification and orientation seating jigs. Universal abutment being milled to accentuate the buccal position of the abutment. Four universal abutments in implant analogs within a maxillary stone model. Maxillary verification jig with universal abutment copings seated on four universal abutments on a stone model. Two resin orientation and seating jigs on their universal abutments on a maxillary stone model, numerals indicating the sequence for the insertion of the first two maxillary universal abutments, Numerals indicating the sequence for the insertion of the second two maxillary universal abutments. Maxillary verification jig with one passive and three retentive universal abutment copings, which verifies a path of insertion and retentiveness of the final prosthesis. Four, universal abutments in implant analogs within a mandibular stone model. Mandibular verification jig with universal abutment copings seated on four universal abutments on a stone model. Two resin orientation and seating jigs on their universal abutments on a mandibular stone model. Numerals indicating the sequence for the insertion of the first two mandibular universal abutments. Numerals indicating the sequence for the insertion of the second two mandibular universal abutments. Mandibular verification jig with one passive and three retentive universal abutment copings. Lab fabrication of a maxillary and a mandibular TRINIA prosthesis. Occlusal side view of maxillary and mandibular substructures milled in a TRINIA disc. Ridge side view of maxillary and mandibular substructures milled in a TRINIA disc. Bonding agent being applied to a TRINIA substructure prior to its bonding to anterior composite denture teeth using a silicone mask. Maxillary and mandibular TRINIA substructures with their bonded anterior composite denture teeth in occlusion. Posterior CAD/CAM hybrid ceramic teeth milled in a disc. Occlusal view of the mandibular TRINIA substructure with bonded anterior composite denture teeth and posterior CAD/CAM hybrid ceramic teeth. Occlusal view of the finished maxillary TRINIA prosthesis on a stone model. Occlusal view of the finished mandibular TRINIA prosthesis on a stone model. Left profile view of the finished maxillary TRINIA prosthesis seated on a stone model with numerals indicating the first sequence for the insertion of the universal abutments. Right profile view of the finished maxillary TRINIA prosthesis seated on a stone model with numerals indicating the second sequence for the insertion of the universal abutments. Facial view of the finished mandibular TRINIA prosthesis seated on a stone model with numerals indicating the sequence for the insertion of the universal abutments, definitive seating of universal abutments, Vaseline being applied to the bore of the orientation and seating jig to facilitate its removal. Two, first sequenced universal abutments being transported to their implants in the Vaseline lined bores of a numerically marked orientation and seating jig. Orientation and seating jig being tapped with a standard seating tip attached to a threaded straight handle to simultaneously seat the universal abutments. Violet two point zero millimeter seating tip attached to a threaded straight handle being used to seat the anterior universal 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 universal abutments. Standard seating tip attached to a threaded straight handle being used to definitively seat the universal abutments. Try in of maxillary TRINIA prosthesis. Universal abutments being transported to their implants in the Vaseline lined bores of a numerically marked orientation and seating jig. Orientation and seating jig being tapped with a standard seating tip to simultaneously seat the universal abutments. Violet two point zero millimeter seating tip attached to a threaded straight handle being used to seat the anterior universal abutments while it is positioned in the orientation and seating jig. Crown removal instrument being used to remove the orientation and seating jig from the universal abutments. Standard seating tip being used to definitively seat the universal abutments. Try in of mandibular TRINIA prosthesis. Intraoral cementation of retentive copings to TRINIA prosthesis. Vaseline being applied to a passive universal abutment coping to facilitate its removal from the universal abutment after its intraoral cementation into a bore of the TRINIA prosthesis. Vaseline being applied to a retentive universal abutment coping to facilitate its removal from the universal abutment after its intraoral cementation into a bore of the TRINIA prosthesis. One passive and three retentive universal abutment copings being seated on their respective universal abutments. Vaseline being applied, but not to the bores, to facilitate the removal of extraneous resin cement after its intraoral cementation to the universal abutment copings. Resin cement being applied to the bores of the maxillary prosthesis. Vaseline being applied, but not to the bores, to facilitate the removal of extraneous resin cement after its intraoral cementation to the universal abutment copings. Resin cement being applied to the bores of the mandibular prosthesis. Cotton rolls being used to apply occlusal pressure during the cementation of the maxillary and mandibular prosthesis to their universal abutment copings. Ridge view of maxillary TRINIA prosthesis with four resin cemented universal abutment copings. Ridge view of mandibular TRINIA prosthesis with four resin cemented universal abutment copings. Vaseline being applied to the mandibular prosthesis to facilitate its easy removal during occlusal adjustments. Placing the mandibular TRINIA prosthesis for occlusal adjustments. Vaseline being applied to the maxillary prosthesis to facilitate its easy removal during occlusal adjustments. Placing the maxillary TRINIA prosthesis for occlusal evaluation. Articulating paper being used to confirm appropriate occlusal contacts. Post insertion view of the maxillary and mandibular telescopic TRINIA prosthesis in occlusion. Occlusal view of the maxillary telescopic trinia prosthesis. Occlusal view of the mandibular telescopic TRINIA prosthesis. Facial view of the maxillary telescopic TRINIA prosthesis. Facial view of the mandibular telescopic TRINIA prosthesis. Patient’s smile with his telescopic TRINIA prosthesis. Post insertion radiograph of the maxillary and mandibular telescopic TRINIA prostheses with anterior composite denture teeth and posterior CAD/CAM hybrid ceramic teeth.