INSTRUCTION MANUAL

2012

SEEGER BRIDGEELASTIC SEEGER BAR

THREAD-REINFORCED-RESINOVERDENTURE

INDEX1 BONONIA IMPLANT SYSTEM - INTRODUCTION3 O.T. EQUATOR TITANIUM ATTACHMENT– INSTRUCTIONS FOR USE4 IMPRESSIONS AND PLASTER MODELS5 TRIAL PLATES IN RESIN – STUDIO / LABORATORY6 FRAME WITH UNDERCUTS – TITANIUM ABUTMENTS7 SEEGER BRIDGE - DIVERGENT INSERTIONS - SEEGER SPRINGS AND TITANIUM ABUTMENTS9 IMMEDIATE LOAD – THREAD-REINFORCED-RESIN12 PROVISIONAL CONSTRUCTION – THREAD-REINFORCED-RESIN16 SEEGER BRIDGE – CIRCULAR BRIDGES - SYSTEM A19 SEEGER BRIDGE – TORONTO BAR CASTABLE ABUTMENTS - SYSTEM A20 SMALL BRIDGES - SYSTEM A22 SEEGER BRIDGE TORONTO BAR TITANIUM ABUTMENTS AND CASTABLE HOUSING - SYSTEM B23 TITANIUM ABUTMENTS CEMENTED DIRECTLY IN THE PATIENT’S MOUTH24 CASTABLE ABUTMENTS WITH BASE AND NON-ROTATING SQUARE PIN25 CIRCULAR BRIDGE ON WIDELY DIVERGENT IMPLANTS27 TRANSFORMATION OF DENTURE FROM REMOVABLE TO FIXED29 OVERDENTURE - TITANIUM O.T. EQUATOR ATTACHMENT WITH TiN COATING31 MINI-MEDIUM IMPLANT33 SURGERY-LABORATORY-SURGERY KIT – CASTABLE O.T. EQUATOR ATTACHMENTS34 O.T. EQUATOR PIVOT - OVERDENTURE ROOTS35 COMPONENTS AND ACCESSORIES

O.T. EQUATOR ATTACHMENTS ARE BUILT FOR EVERY MODEL AND BRAND OF IMPLANTS AVAILABLE ON THE MARKET

Orders should be precise with the following in-formation provided:

- Model and brand of the implant- Diameter of the implant- Height of the abutment

Height from 0.5 to 7 mm for internal hexagon implantsHeight from 1.7 to 7 mm for external hexagon implants

Some implant brands are dispatched on the same day of order, whereas orders for les-ser known brands are dispatched within 3-4 days.

HOW TO ORDER O.T. EQUATOR ATTACHMENTS

The O.T. Equator attachments are also supplied in small quantities (two or three pieces) or in large numbers directly to the implant manufacturers

A project of the MIUR Rhein 83 research laboratory with the collaboration of the

University of Modena and Reggio Emilia at the Medicine and Surgery Faculty.

The Department of integrated activity in Head-Neck Specialized Surgery.Research and development centre of diagnostic and therapeutic

methodology in reconstructive surgery, implant prosthetics and dental materials.

Director Prof. Ugo Consolo

BONONIA IMPLANT SYSTEMBononia Implant System presents a new prosthetic implant technique created out of a spheri-cal evolution by modifying the O.T. Cap sphere and generating the O.T. Equator attachment. It is a universal prosthetic anchoring that allows you to connect both fixed and removable prosthetic devices. This pillar can be used on any implant system and aims to simplify operating procedu-res and clinical techniques. Implant manufacturers often have systems that involve the use of transmucosal components for the various phases of creating the fixed or removable prosthesis. These components are often specific to each implant system. Each manufacturer tends to di-scourage the use of pillars that are not included in their own surgical-prosthetic catalogue as well as believing the use of machined titanium components by other manufacturers is risky. However, it is arguable that in clinical practice it is acceptable to rehabilitate a patient with castable prosthe-tic abutments to be transformed in lost wax casting. Most operating protocols, moreover, provide for the use of various provisional pillars specific to the early healing stages of the peri-implant soft tissues that are later replaced by the definitive pillars. However, literature tends to criticize the re-placement manoeuvres of the implant abutments and the continuous screwing and unscrewing of these pillars for the potential detriment of the gingival junction at the level of the transmucosal path which may lead to an increase of peri-implant bone resorption. The O.T. Equator attach-ment is used in fixed prostheses combined with an elastic spring called Seeger that simplifies and improves the connection of the prosthetic implant. Another feature of this abutment regards the problems related to the undercut and the divergence between the implants, solved without using additional accessories such as an MUA, or without having to build cast parallel abutments or Cad-Cam products. The ideal goals of the transmucosal O.T. Equator implant pillar consists in simplifying the operation procedure through the use of a single pillar without needing a replace-ment during the entire treatment. The system concentrates the functions of the healing screws, the provisional pillars and the definitive pillars onto a single screw piece, for both the cases of overdentures and fixed prosthesis. It follows that all sessions with the patient and any interim operations (impressions, test and application of the finished denture) are performed in minutes with the O.T. Equator abutment which is already found screwed onto the implant. An important biological advantage follows this since compliance with the transmucosal collar from the very first surgery and the subsequent preservation of the connective and epithelial joint contributes to the prevention of peri-implant bone resorption. Finally a prosthetic advantage is given by the various anchoring solutions on the same pillar with the chance to modulate the degree of retention in the removable prosthesis, while in the fixed prosthesis it allows the clinician some interesting operational options to overcome the divergence between implants getting a high aesthetic value in the Toronto Bridge prosthesis. The stability of the fixed prosthesis on the implant is ensured with the use of Seeger springs, avoiding the unscrewing of screws and any possible breakage. Furthermore, the technical devices coupled to the Seeger springs housed inside the abutments allow the insertion of the frame on divergent implants measuring a 45-50°divergence.

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Bononia Implant System is a new universal im-plant-prosthetic technique. The O.T. Equator was created from the spherical evolution. The Seeger Bridge springs and Elastic Seeger Bar were created from a technical evolution.Bononia Implant System is a complete implant-pro-sthetic system from surgery to the prosthesis.This manual is a protocol and a guide for operators, dentists and dental technicians. By continuing to ap-ply the O.T. Equator abutment during surgery and by following the technical advice, you can achieve important biological results as well as simplifying all the procedures with quality technical results.

BONONIA IMPLANT SYSTEM

(3) All the procedures, including the delivery of the patient’s finished prosthesis, are extremely simple. The temporary prosthesis, remo-vable or fixed, is always anchored to the O.T. Equator attachment and it is practical to remove the prosthesis from the attachment and then remount it after the impressions and the various trials.

THIS MANUAL GUIDES OPERATORS IN ALL PHASES FROM SURGERY TO THE PROSTHESIS(1) gengiva libera

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(6)All of these sessions in the patient’s mouth (always working on the O.T. Equator attachment and never intervening on the inside of the implants) are performed in a short time of 15 to 30 minutes each. By operating in this way the ligaments of the soft tissues to the Titanium are maintained intact so as to be a protective barrier for the underlying implant.

Whoever presents a new technique, needs to demonstrate that it has been tested for several years by qualified professionals, to ensure its performance and efficiency.

To understand and evaluate the efficiency of a new technique, careful asses-sments should be made:- bear in mind the difficulties faced daily with the usual techniques- search for solutions in new techniques by identifying the possible advantages

(6) The mounting of the finished bridge is done by applying pressure to trigger the Seegers over the equator of the hemispheres and lock the bridge to the O.T Equator attachments.

(1) By always applying the O.T. Equator during surgery without taking it apart we achieve a link between the soft tissues and the Titanium surface; this simplifies all future prosthetic procedures.

(2) The O.T. Equator implant is not removed even while taking the impression as the transfer is placed on the sphere of the attach-ment.

(4) The impression of the centric articulation is made easier by having it done with resin plates, stabilized above the O.T. Equator attach-ments with retentive elastic caps.

(5) The teeth trial is also done with plates stabilized above the O.T. Equator attachments, involving the patient and the dentist who toge-ther evaluate the aesthetics, size and phonetic results. The cast fra-me of the bridge can be tested in the same or subsequent session.

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BONONIA IMPLANT SYSTEMSOME OF THE PREROGATIVES AND ADVANTAGES COMPARED TO OTHER TECHNIQUES

The O.T. Equator attachment is applicable with all models and brands of implants without the purchase of new equipment, using equipment normally found in use in any studio or laboratory.

SEEGER AND TOLLERANCESAll implant manufacturers use Titanium in their accessories and compo-nents constructed with the utmost precision with minimum tolerances between them. Some of these details create problems for the dentist or dental technician in designing a prosthesis on divergent implants as they have to resort to laborious and at times technically risky procedures. This is why the Seeger springs were created to eliminate any contact between the connective components of the prosthesis to the implants, easing their insertion and at the same time improving and guaranteeing the maximum hold.

The Seeger springs are the most important innovation of the system because they ensure the passivation and the locking of the prosthesis. The screws do not unscrew and do not break.

In highly accentuated undercuts between the implants, stability is achieved with only the Seeger without screws, simplifying the solution and preserving the aesthetics.

Working time is reduced by 50% - 60% in the studio and the laboratory.

It is possible to guide and maintain the perimeter gum with the retention caps and the tear-off mini transfer.

Using extra-grade abutments, the passive prostheses are also inserted onto divergent implants with a divergence of more than 50°.

Using Mini-Medio implants, single overdenture pros-thesis and Elastic Seeger bar prosthesis are applied and individual teeth can be replaced.

INSTRUCTIONSTHE ABUTMENT – THE O.T. EQUATOR ATTACHMENT IS ALWAYS MOUNTED DURING SURGERY SESSION

DENTAL PRACTICEAlways mount the O.T. Equator abutment during surgery instead of he-aling screws, both in the uncovering of the already osseointegrated im-plants as well as in the immediate load implantology without removing them anymore. We recommend tightening the implant attachments by hand as much as possible; tighten it firmly, unscrew it and screw it back up again tight. Repeating this process two or three times, you will notice that the attachment seems locked to the implant. This manoeuvre cre-ates a kind of adaptation between the male and female threads of the screw which subsequently are very likely to unscrew. After this operation, if necessary you can tighten the lock with a dynamometer of 15 to 20 Newtons.

Mounting the O.T. Equator attachment during surgery you achieve the matching and the ligament of the soft tissues to the Titanium surface. This will be a barrier in the future defence of the underlying implant. By not having any communication with the outside it will not be subject to any leakage. This is also due to the threaded hole on the head of the O.T. Equator attachment as it is a closed hole.

Free gums

emidesmosomial ligamentconnective ligament

THERE ARE THREE TYPES OF TRANSFERS FOR TAKING IMPRESSIONS

Titanium Transfer with passing holes and locking screws to screw the attachment in the mouth. These impressions are taken with an individual impression tray prepared with corresponding passing holes to the transfers. These holes are sealed with soft wax to hold the impression material allowing for long screws to pass over the wax and be unscrewed so as to take off the impression from the mouth once the silicon has set.

The tear-off plastic transfer to take impressions is mounted above the O.T. Equator attachment. In this case, silicon and a standard impression tray is used. Use the blue inserter to insert the transfer onto the attachment in the mouth.

IMMEDIATE LOADTear-off plastic Mini Transfer to take an impression of the patient’s mouth after surgery to immediate load using the temporary bridge (which was previously tested and dug out internally along the alveolar ridge) as an impression tray. Use the blue inserter to insert the Mini Transfer onto the O.T. Equator attachments (see also the immediate load prosthesis on page 10)

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Techniques which do not involve mounting on the fixture after sur-gery of the definitive connecting element with the prosthesis require that all successive procedures (including the delivery of the finished prosthesis) remove the connecting supports with the prosthesis from within the implant, with the following drawbacks:- the tearing of ligaments between the Titanium and soft tissues;- pain and bleeding that sometimes require anaesthesia;- time-consuming tests due to the mounting and unmounting of temporary prostheses and the attention spent in not confusing the various supports tailored for each implant.

O.T. EQUATOR: COMPARISON WITH OTHER TECNIQUES

IMPRESSION PREPARATION AND PLASTER MODELS

LABORATORY

Titanium transfers:Insert the impression with the Titanium tran-sfers with the O.T. Equator stainless steel analogues and lock it onto the opposing side of the impression by tightening the long screw.

Tear-off plastic transfers:First insert the stainless steel analogues into the seat of the tear-off plastic transfer, then insert the transfer into the impression.

IMMEDIATE LOAD:Tear-off plastic Mini TransferFirst insert the stainless steel analogues into the seat of the tear-off plastic transfer, then carefully insert the transfer into the impres-sion. To stop it you can use a small amount of glue. Pour the plaster carefully.

PLASTER MODELS WITH THE O.T. EQUATOR STAINLESS STEEL ANALOGUES

Develop the plaster model carefully by respec-ting the water/plaster proportions and the set-ting time recommended by the manufacturers.

IMMEDIATE LOADThe models are mounted in the articulator before removing the impression. In plaster models with the O.T. Equator stainless steel analogues, there is no need to create sili-con or soft resin gums as the stainless steel analogues are always on the surface and the surrounding plaster does not break during the work

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THE CONSTRUCTION OF RESIN TEST PLATES WITH O.T. EQUATOR RETENTION CAPS

ONE OF THE ADVANTAGES OF THIS SYSTEM

LABORATORY(1) Insert the retentive caps (black or yellow) inside the stainless steel housings and mount them above the O.T. Equator analogues.(2) Build a small resin plate that encom-passes the containers. (3) Apply a wall of wax (bite) onto the resin plate

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DENTAL PRACTICE

TRIAL PLATES INSIDE THE PATIENT’S MOUTHLOCKED ONTO THE O.T. EQUATOR ATTACHMENTS

Due to the stability of the plate inside the patient’s mouth blocked above the O.T. Equator attach-ments, it is easy for the dentist to take the ver-tical and centric dimen-sions without any errors.

MODELS ON ARTICULATOR LABORATORYOnce the gnathologic data have been set on the articulator, remo-ve the bite from the plate. Mount the prefabricated teeth (available commercially) onto the resin plate, treating the size and appearance of the test prosthesis with precision as if it was the final piece.

RESIN PLATES, FUNCTIONAL AND AESTHETIC TRIALS IN THE PATIENT’S MOUTH

Thanks to the stability of the plate, the patient is involved during these tests and is able to eva-luate the appearance and phonetics and have a precise idea of how the final work will be.

Not having to remove the O.T. Equator attach-ment, the dentist can perform these tests with confidence and in a few minutes. Following the indications from the trial, the work can be fini-shed as planned with resin, composite or ce-ramic teeth.

DENTAL PRACTICE

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MODELS ON ARTICULATOR

RESIN PLATES, FUNCTIONAL AND AESTHETIC TRIALS IN THE PATIENT’S MOUTH

DESIGNING FIXED FRAMES WITH DIVERGENCES AND UN-DERCUTS BETWEEN THE IMPLANTS

The undercut between the implants is common and is a daily challenge for those involved in the building of prosthetic devices that meet the requirements of the clinician, above all the passive insertion of the structure on the fixture.

Significant progress has been made with the Bononia Implant System, but to solve some special cases, this technique should be applied with a study and an appropriate project regarding each individual patient. To overcome undercuts between the implants and to passivate the frames, it is necessary to design the prostheses in a laboratory with an

insertion line that varies according to each prosthetic project.

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NORMO TITANIUM ABUTMENTS

EXTRAGRADE TITANIUM ABUTMENTS

CASTABLE ABUTMENTS

“A”

“B” “C”

(foto1)

(foto2) (foto3)

(foto4)

“A”“B”

When the divergence on the model shows a radial pattern (Fig. 2), the project may be more complex. In these cases, building the frame requires the use of Extra-grade Titanium abutments (Fig. 3) and turn the indented inner rim of the abutments in the direction of the undercuts; also the Seegers inserted in the abutment should have the opening of the spring facing the undercut. The case is simplified in this project, reducing it in two insertion lines. The structure is inclined and inserted on the line “A” fixture first of all and then on the “B” line (fig. 4).

When there is a pronounced divergence between six or seven implants, Extragrade abutments should be used on all the abutments with O.T. Equator attachments; only some of the abutments (four or five) should be selected to connect with the Seegers and the through screws. In the remaining implants (two or three) the locking of the frame should be entrusted solely to the O.T. Equator attachments with the Seegers without through screws. In these cases the project should be done with a balanced distribution of the screws and the Seegers (it would be wrong to design it with all the Seegers and screws on one side of the bridge with only Seegers on the other side). Even without screws, the stability of the Seeger springs ensures a tight fit since they are not subject to wear. In the frontal sections the locking with only the Seegers sometimes solves aesthetic problems too, where the passage of the screws on widely diver-gent implants would disfigure the appearance and could weaken the tooth.

In cases where there are undercuts arranged in straight lines (Fig. 1) you will need to insert the finished prosthesis firstly on the O.T. Equator attachments arranged along the “A” line, holding the prosthesis inclined in the direction of the divergence of the incisal implants, then compress the prosthesis in zone B and C and snap the Seegers into place over the O.T. Equator attachments.

TITANIUM ABUTMENTS ARE THE ALTERNATIVE TO PREVIOUS TECHNIQUES THAT WERE MORE COMPLICATED AND EXPENSIVE

DIVERGENT INSERTIONSSEEGER SPRINGS: HOW AND WHY THEY WORK

INSIDE THE ABUTMENTSINSIDE FIXED SEEGER BRIDGE PROSTHESIS

THERE ARE TWO TYPES OF TITANIUM ABUTMENTS FOR FIXED PROSTHESIS

NORMO TITANIUM ABUTMENTS internal ø 3mm ø 3mm

EXTRAGRADE TITANIUM ABUTMENTS internal ø 3mm more indented from 0.67mm ø 3.17mm

SPHERE OF THE O.T. EQUATOR ATTACHMENT external ø 2.5mm

ø 2.5mm

ELASTIC SEEGER SPRING WITH HANDLE FOR SEEGER BRIDGE FIXED PROSTHESIS

THE NORMO TITANIUM ABUTMENTS for fixed prosthesis have a circular internal diameter of 3 mm. The sphere of the O.T. Equator attachment has an external diameter of 2.5 mm; during the assembly of the prosthesis on the implants, the gap between the abutment and the attachment allows you to overcome any divergence from 35° to 40° depending on the prosthetic project.

The sphere of the O.T. Equator attachment is never centred with the hole of the abutment during the insertion of the prosthesis. The circular tolerance between the two Titanium parts is 0.25 mm around all the perimeter (when the sphere for reasons of divergence finds itself all onto one side with the opposite side having the space of 0.5 mm between the sphere and abutment).

EXTRAGRADE TITANIUM ABUTMENTS with an inner circular diame-ter of 3 mm plus the Extragrade indentation of 0.17 mm have to be used in prosthetic cases with widely divergent implants. The indented inner rim of the abutments (where the direction is also indicated exter-nally) should be installed according to the project and aligned in the direction of the undercut of the implant where the indentation increases the tolerance between the Extragrade abutment and the equator of the hemisphere of the O.T. Equator attachment, obtaining the pos-sibility of the insertion of the prosthesis with divergences of more than 50 °.

ø 3mm

ø 3.17mm

When mounting the bridge on the model or in the mouth (for reasons of the project and divergence) the sphere of the attachment is found in the indentation of the Extra-grade Titanium abutment. On the opposite side, the distance of the sphere from the circular perimeter of the abutment is 0.67 mm. When the prosthesis is assembled, the Seegers in the abutments bridge the gap between the hemisphere and abutments giving position and stability to the prosthesis.

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During the insertion of the prosthesis on the model, the Titanium abutments with Seegers on the inside meet the hemispheres of the O.T. Equator attachments which, being slightly rounded at the top, re-ceive the pressure from the frame and favour the feeding of the See-gers. The Seegers, thanks to this push, widen at the tip and snap the frame into place over the attachments. As the Seegers are slightly ela-stic, they tend to flatten slightly at some other point of the perimeter until they snap the frame of the bridge into place. The elastic memory allows the Seegers to regain their shape in a short time and complete the seal.

The click of the bridge across the O.T. Equator attachments (so as to go into position in the patient’s mouth above the boneintegrated im-plants) does not cause any traumas. Once the bridge is inserted with the Seegers and the screws tightened you obtain passive stability. In rare cases, some small tractions could remain caused by excessive divergence or a few minor inaccuracies. These tractions would be borne by the Seeger which in some point could have a non-passive contact.The Seeger, being slightly elastic and maintained at a temperature of around 36 ° in contact with the boneintegrated implant (stable in the bone), is forced to yield and adapt quickly to resume its function as the element of passivation.

LABORATORY TESTEXTRAGRADE TITANIUM ABUTMENTDIVERGENCE BETWEEN IMPLANTSFROM 0° TO 55°

(A) 1 O.T. Equator attachment on the analogue of 0°.(B) 2 O.T. Equator attachments on diverging analo-gues of 55°.(C) Counterparts with Extragrade Titanium abutments with Seegers inserted, note the opening of the Seegers facing in the direction of the under-cut.(D) Extragrade Titanium abutments during the inser-tion onto the O.T. Equator attachments.(E) Extragrade attachments inserted on the O.T. Equator attachments with a divergence of 55°, over the Seegers in the abutments, mounting a single screw on the attachment at 0°. The two parts lock stably without the possibility of disassembly.

(A) (B)

(C) (D) (E)

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IMPLANTOLOGY AND IMMEDIATE LOAD PROSTHESISSURGERY AND THREAD-REINFORCED-RESIN BRIDGE

For immediate load implantology, the Bononia Implant System method expects that a temporary semi-finished prosthesis should be prepared before surgery, which should be designed and built each time according to the patient’s situation. Here we present the case of a patient with four residual front teeth and two roots that will be extracted. It requires two alginate impressions, one upper and one lower and a wax bite with the gnathologic data necessary to mount the models in the articulator. A temporary semi-finished bridge in resin is prepared. This bridge, once the surgery is finished and while the patient rests for around two hours, is built and finished in Thread-Reinforced-Resin and fixed in the mouth over the O.T. Equator attachments. The patient leaves the session with a sturdy,

hygienic and aesthetic fixed bridge that can remain in the mouth for a long time (6-8 months or more).

LABORATORY Alginate impression, plaster models and wax blocks.Articulator models. Mounting resin teeth (prefabricated available commercially) in the edentulous side areas.

LABORATORY A partial prosthesis with an extended palatal plate is built with transparent resin.

DENTAL PRACTICE The temporary semi-finished prosthesis is tested before surgery and the articulation is functio-nalized and regularized, filing away any interference and the contact points with a burr.

DENTAL PRACTICE The centric articulation is detected and precisely locked with a self-curing resin key. This key and the base of the plate in contact with the palate guarantee the recovery of the articulation data after surgery.

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LABORATORY After the test and functionalization of the temporary prosthesis in the mouth (while the dentist surgi-cally proceeds), the incisor teeth are extracted from the plaster model in the laboratory and the resin teeth are mounted respecting the previous line, nevertheless improving the aesthetics. Once completed in resin, the temporary prosthesis is hollowed out abundantly along all the dental arch where the implants will presumably be inserted. It will then be adapted and used as individual impression tray.

DENTAL PRACTICE Once the surgery is finished, the teeth have been extracted and the implants positioned (on which are screwed the O.T. Equator abutments of an adequate height to the soft tissues); following the advice regarding screwing, tighten and loosen the attachment on the implant a few times until it feels locked. This is how you obtain that type of adaptation between the female screws of the implant and the male thread of the attachment, which are unlikely to loosen. Insert the tear-off Mini Transfer to make an impression above the O.T. Equator attachments using the special blue inserter.In cases where it is possible to determine the height of the abutment before surgery you can order a specific number of O.T. Equator attachments.

DENTAL PRACTICE In the mouth above the Mini Transfer, the temporary bridge that was indented along the alveolar ridge is tested and will act as an individual impression tray. The temporary prosthesis will have to adhere to the palate and, in closing the mouth, the antagonist will cross over with the resin occlusal key, previously marked by the antagonist.

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ASSORTMENT KIT42 O.T. EQUATOR ATTACHMENTS

ABUTMENT H from 0,5 to 7mm

DENTAL PRACTICE The temporary prosthesis remains stained with red at the contact points with the Mini Transfer. In the stained points you will have to file and widen extensively without fear. Should you damage a tooth, it can be repaired without any problem during finishing. Try the temporary prosthesis in the mouth before making an impression.

DENTAL PRACTICE To make an impression using the temporary bridge with the palate, use a solid position material (elastomer) and have the patient close their mouth. The resin key guides the antagonist into place and will be able to precisely locate centric occlusion.

DENTAL PRACTICE Test and check that there is no interference between the Mini Transfers and the temporary prosthe-sis. A valid verification (without using a checking paste) can be done by dirtying the Mini Transfers with lipstick.Replace the temporary prosthesis in the mouth.

DENTAL PRACTICE The patient rests for about two hours while they wait for the temporary finished bridge.

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CONSTRUCTION OF THE THREAD-REINFORCED-RESIN TEMPORARY BRIDGE

WITH TITANIUM ABUTMENTS WITH PASSING HOLES

LABORATORY The execution of the temporary bridge in this case is particularly dif-ficult for the significant undercuts of the implants. You should plan to build the bridge and fix it in the patient’s mouth on four implants with the Seeger and the screw, while it is enough to lock the bridge with only the Seegers without screws onto the remaining two implants.To cast the model, first of all insert the stainless steel analogues in the Mini Transfers, then place them carefully into the impression. You can use glue to lock the Mini Tran-sfers in place in the impression.

LABORATORY Pour the model carefully and mount the articulator using a quick-setting plaster. Remove the excess silicon from the model in the labial area and make a template of all the arch which will be useful in evaluating the spaces and in buil-ding the frame as a temporary internal Thread-Reinforced-Resin bridge.

LABORATORY To build the reinforced structure proceed by using the Titanium abutments with passing holes and ortho-dontic thread of ø 0.8 mm. Melt the thread over a flame and thread it into the Titanium abutment holes as if they were pearls. The abutments are connected by steel threads and locked with each other with resin to form a complete frame that is both passive and robust.

LABORATORY Mount the first abutment above the analogue by tightening the screw within, bend and adapt the thread in correspondence with the proximal analogue, mount the other abutment and the screw and proceed until the entire arch has been completely reinforced. Evaluate the spaces with the silicon mask, fill and adapt the Titanium abutments. Eliminate the resin plate in the semi-finished temporary prosthesis; save only the resin teeth and place them in the template.

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LABORATORY Lock all the abutments with thread between them, from the pa-latal side an additional thread of greater diameter along all the arch is added to the frame to make this bridge more robust. With the silicon mask in place (given the significant divergence) the long screws protrude through the holes, made in their correspondence to the silicon template.

LABORATORY Pack it with self-curing resin and cook it in a hydrofla-sk. Finish and polish the Thread-Reinforced-Resin bridge.

LABORATORY Please note the difficulty in removing the bridge from the model after curing the resin due to the conside-rable divergence of the O.T. Equator attachments. With a burr you can carefully create an indentation within the Titanium abutment with passing holes to get the Extragrade abutment effect to overcome the undercuts and favour the insertion of the bridge in the mouth. The Seegers should be inserted into the abutments inside their housings, rotated with a tip with the opening in the direction of the indentation and the undercuts. This bridge is fixed in the patient’s mouth with Seegers and screws in four abutments; in the other two the Seegers are used without any screws.

LABORATORY It has not been possible to build Titanium abutments with passing holes with Extragrade indentation using mechanical production methods. Mounting the Titanium abutments with passing holes on widely divergent implants (in order to favour the insertion of the fini-shed Thread-Reinforced-Resin bridge into the patient’s mouth) the dental technician, with a burr and care, can create an indentation and make the perimeter similar to the Extragrade type abutment at the point of the undercut.

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DENTAL PRACTICE After about two hours, the finished temporary bridge in the patient’s mouth with only four screws. In two other attachments (to ensure the stability and appea-rance) only Seegers have been inserted to avoid unsightly ho-les. The labial holes in the canine teeth resulting from through screws are sealed with a composite of a matching but slightly different colour to be able to identify and reopen them when you have to remove the bridge. Lower, two immediate load implants, small Thread-Reinforced-Resin bridge.

For a better hygiene on the implants where only Seegers are mounted without any screws, you can close the square-headed hole to the attachment with the temporary elastic self-curing cementum, or tighten the little closing screw.

TEMPORARY THREAD-REINFORCED-RESIN BRIDGESOME INDICATIONS

The Thread-Reinforced-Resin bridges solve a functional and aesthe-tic problem in a simple way. Leaving the studio with fixed and aesthetic teeth in the mouth when the surgery has been completed is a much appreciated result for the patient and is equally beneficial to the dentist who sees the patient again after 8 days to remove the stitches (without removing the bridge).The total time of these surgical sessions varies from 4 to 5 hours (including the time when the patient rests awaiting the temporary bridge). The patient leaves the studio with the sturdy and aesthetic temporary bridge which will remain in his mouth until the delivery of the final bridge.

This temporary bridge is designed accor-ding to the situation of the mouth and the problems vary each time. In the case of an edentulous patient wearing a removable prosthesis completely in resin, the same dentures can be reused transforming it in a simple way into a Thread-Reinforced-Resin Bridge

It is important in all cases to build a semi-finished temporary prosthesis in resin, adapt it, detect the articulation before sur-gery and always lock it with the resin key, so as to find the position and centric arti-culation again after surgery.

Thread-Reinforced-Resin Bridges:Lower jaw, 11 implants with O.T. Equator attachments. Pla-ster models with silicon templates, abutments with passing holes mounted above the analogues, frame with steel th-read of ø 0.8mm locking all the abutments, thread for ad-ditional reinforcement over the entire arch. Bridge fixed in the patient’s mouth over the implants with O.T. Equator at-tachments.Vision, with the mirror, of the small fixing screws. Panoramic X-ray: note the two temporary circular bridges (applied above previously). The lower Thread-Reinforced-Resin bridge was applied in the previous session.Both bridges are removed after the boneintegration of the implants.

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When mounting the final prosthesis on the patient, these temporary bridges are kept conserved since they may be reused in the future if necessary.

Dott. P.Angelini

Prof. M.Cirulli

Dott. T.Grandi

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SEEGER BRIDGESYSTEM A

FIXED SEEGER BRIDGECIRCULAR BRIDGES AND TORONTO BAR WITH

CASTABLE ABUTMENTS CONNECTION SYSTEM A

Castable AbutmentLong screwShort screwWhite SeegerPink laboratory SeegerStainless steel analogueCastable connection bar

CIRCULAR BRIDGE ON FIVE IMPLANTS WITH SCREWED O.T. EQUATOR ATTACHMENTS The project involves the lo-cking of the bridge on four at-tachments with Seegers and screws. On a widely diver-gent attachment, from which the screw inserted in the la-bial area of the canine to sta-bilize the prosthesis would protrude, only Seegers are mounted without any screws.

Impression taken with Ti-tanium transfer with long through screws mounted on the O.T. Equator attach-ments. Impressions taken with stainless steel analo-gues locked in their place with long through screws on the opposite side of the impression.

Plaster model, resin trial plate with retentive elastic caps and wax bite to take a stable impression of the centric relation in the pa-tient’s mouth.

Stable trial plate in the patient’s mouth, locked on the O.T. Equator attachments thanks to the retentive caps.The vertical and centric dimensions are marked in the wax. Models mounted in the articulator.

16

CIRCULAR BRIDGE DEFERRED LOAD

Mount the models in the articulator and clean wax off the resin trial plate. The resin teeth are mounted. This test in the mouth (thanks to its stability) allows the patient and the dentist to evaluate not only the aesthetics, but also the phonetics and the space taken up by the prosthesis as if it was finished.

A template is made in the la-boratory to assess the spaces available and the castable abutments for the Seeger Bridge fixed prosthesis are mounted above the O.T. Equator attachments. Some pieces of castable connec-tion bar are cut and adjusted between the abutments.

Combine the various pieces to the small areas with resin (to avoid retractions), wait for the curing of these areas and proceed until the union with the entire structure has been completed. Finish the model-ling of the frame with wax, careful-ly adjust the thickness to the length of the frame.

The casting pins are applied on the basis of personal experien-ce.

Finished and polished casting. Casting inserted on the model with only one Seeger to stop it and faci-litate the test in the mouth.

Trial of the cast structure in the pa-tient’s mouth, the Seeger stabilizes the cast in the patient’s mouth and allows the tightening of the other screws with ease and locks the structure to check its accuracy.

17

Finished prosthesis, clean the housings well with a special burr be-fore inserting the See-gers. Once the Seegers have been inserted, ar-range them inside the cast abutments with the appropriate tool in the shape of an Equa-tor sphere.

Finished bridge in articulator. Finished bridge on the model.

Bridge in patient’s mouth. The abutment of the bridge on the im-plant in the canine area is fixed with only See-gers without screws, because the inclination would compromise the aesthetics letting out the screw in the central part of the tooth in the vestibular area. In the other four implants, the bridge is fixed with Seegers and four short screws.

The short screws con-tained in the package should NOT be used in the laboratory but only in the patient’s mouth to secure the finished work.

SEEGER BRIDGE: FIXED CIRCULAR BRIDGE SYSTEM A ON SIX IMPLANTSThese circular bridges are built with one-piece casting castable abutments. The structure, although strong,

is less invasive for hygienic benefits.

18

With the Seeger Bridge technique, you can build bridges in Cad-cam, Zirconium or Titanium.

FIXED SEEGER BRIDGE PROSTHESISCIRCULAR BRIDGES AND TORONTO BAR WITH

CASTABLE ABUTMENTS CONNECTION SYSTEM A

Castable AbutmentLong screwShort screwWhite SeegerPink working SeegerStainless steel analogueCastable connection bar

FIXED TORONTO BAR PROSTHESIS WITH CASTABLE ABUMENTSImpression taken with plastic tear-off transfers

LABORATORY After testing the teeth in the patient’s mouth, make a template and, on the model, mount the castable abutments above the analogues and secure them with long screws.

Cut portions of the blue connec-tion bar to join the abutmentsMake small notches on the abutments and on the bars to en-sure the hold of the resin.

Combine the various pieces to the small areas with resin (to avoid retractions), wait for the curing of these areas and proceed until the union with the entire structure has been com-pleted.

Finish the modelling of the fra-me on the castable structure with wax, brace the thicknes-ses at the points corresponding to the castable abutments and before the extensions (cantile-ver).

19

The casting pins are applied on the basis of personal experience.Casting sandblasted on the mo-del. Casting sandblasted, fini-shed and polished.

Clean the Seeger housing well with the appropriate burr. Once the Seegers have been inserted, arrange them inside the cast abutments with the appropriate tool in the shape of an Equator sphere, finish the pros-theses with resin.

Before sending the prosthesis to the den-tist, check that the Seegers have not been stamped out or dama-ged during the work. In such a case, remove and replace them with new ones.

The short screws contained in the package should NOT be used in the laboratory but only in the patient’s mouth to secure the finished work.

SEEGER BRIDGE: SYSTEM A SMALL BRIDGES WITH CASTABLE ABUTMENTS

20

4 Seegers and only 3 screws

SEEGER BRIDGESYSTEM B

21

FIXED SEEGER BRIDGE PROSTHESISCIRCULAR BRIDGES AND TORONTO BAR WITH TITANIUM ABUTMENTS

AND CASTABLE CONNECTION HOUSING – SYSTEM BTITANIUM ABUTMENTS CEMENTED TO THE CAST HOUSING

Normo Titanium abutment

Stainless steel Analogue

Castable connection bar

FIXED SEEGER BRIDGE TORONTO BAR PROSTHESIS PROJECT WITH ABUTMENTS IN TITANIUM AND CASTABLE HOUSING

The frame is designed according to the diverging positions of the implants. Normo or Extragrade abutments can be used. We will use five Normo Titanium abutments in this project.

Normo Titanium abutments are mounted on the Equator analo-gues and are locked with long screws. Insert the castable hou-sings into the abutments. Cut the portions of connecting bar to size and make small notches with a burr in order to make the connection with the resin more secure.

Connect the parts with the resin, proceed to the areas and light cure until a strong supporting frame has been built; if necessary, reinforce the junction points between the housing and bar with some other self-curing resin.

Check the spaces available with the silicon template.Model and complete the structure with wax on the ca-stable frame. The casting pins are applied on the ba-sis of personal experience. Check that no abutment remains within the housing and melt.

Casting sandblasted, finished and polished. To fix the abutments to the cast housings with anaero-bic cement, prepare Vaseline, pieces of worn-out burrs or pieces of wax tips with a 2.5 mm diameter.

22

Castable housing

Long screw

Extragrade Titanium abutment

We decided to cement the abutments in three phases. The Titanium abutments are mounted with Seegers in-serted above the first two analogues. The insides of the passing holes are isolated with Vaseline and the pieces of worn-out burrs are threaded through.

Spread mixed ce-ment outside the abutments and the holes of the housings. The cast will be inser-ted through the Tita-nium abutments.

With the cast inserted, take off the little pieces of burr that once extracted leave the hole clean of cement. In-serting the long screws, the frame takes its position. It is recommended to put ano-ther two long screws on the opposite side of the frame to make sure that the bar is in place. Clean the excess of hardened cement and proceed to the cementation of the other abutments.

Once all the abutments are cemented, finish the prosthe-sis with resin teeth. In cases where the project includes ceramic teeth, the Titanium abutments are cemented to the frame in the finished ce-ramized work.

SEEGER BRIDGE: TITANIUM ABUTMENTS CEMEN-TED DIRECTLY INTO THE PATIENT’S MOUTH

In some cases it is possi-ble to cement and fix the abutments to the trial or finished prosthesis, even in the patient’s mouth. In this way you are assured of obtaining the maximum accuracy and passivation.

SEEGER BRIDGE: SMALL TITANIUM ABUTMENT BRIDGES CEMENTED ONTO THE MODEL

Even in small bridges it is possible to cement the Tita-nium abutments to the pros-thesis on the model or in the patient’s mouth (in the trial or finished version), thereby assuring maximum precision and passivation.

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CASTABLE ABUTMENTS WITH BASE AND SQUARE NON-ROTATING PINTEAR-OFF PLASTIC TRANSFER WITH A STAINLESS STEEL

NON-ROTATING SQUARE CONNECTION PIN

THESE COMPONENTS ARE USED TO TAKE THE SAME POSITION AND DIREC-TION OF THE O.T. EQUATOR ATTACHMENT FROM THE MOUTH TO THE MODEL

Tear off plastic transfers with a stainless steel square non-rotating connection for taking the im-pression inside the patient’s mouth.

Castable abutment with base and square non-rotating pin to build parallel cast abutments.Pink Working Seeger with handle.

In special cases it is possible to design fixed prostheses on widely divergent im-plants using abutments with castable ba-ses and square pins.

To take the impression, firstly insert the ana-logue in the transfer and then insert it inside the lodge of the impression making sure that the flat wall of the transfer corresponds to the position of the impression.

The castable abutments with square pins are used to create cast abutments in parallel with each other where the crowns are cemented.

Put the pink Seeger in its dedicated housing on the castable base and insert it on the analogue. Make the square pin pass through the hole of the base and rotate it until it comes into position in the square of the analogue below.

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Lock the two parts with self-curing resin, remove the external excess and shape the abutments with wax. Parallel abutments with only very-tapered supports and without milled parallel walls have been modelled in the prosthesis.

According to the project and the insertion plan, abutments can be built with parallel conical walls, milled and graded according to the divergence.

A CIRCULAR BRIDGE PROJECT ON WIDELY DIVERGENT IMPLANTS

The project is that on three incisor implants, three castable abutments are used for a fixed Seeger Bridge prosthesis that will lock the bridge in the patient’s mouth with Seegers only and without screws. On the other implants castable abutments with base and square pin are used to shape the parallel cast support abutments along the alveolar ridge.The crowns of the bridge are fixed in the patient’s mouth on the abutments with the temporary cement so as to have the chance to remove the bridge in the future.

Wax modelling of the parallel conical abutments wi-thout being milled. Model with reference points mar-ked in pencil on the model and repeated in the ca-sting, in order to remount the abutments in place after the casting in a practical way.

Model the caps on the abutments with self-curing resin. Complete the model-ling of the structure in resin in small are-as to avoid retractions. Wait for the cu-ring, combine the remaining areas and complete the modelling with wax.

The casting pins are applied on the basis of personal experience.Casting sandblasted and polished.

Finished bridge with white See-gers inserted into the incisor abutments. Bridge on the model and aesthetic appearance.

25

Sandblast and clean the inside of the cast abutments thoroughly, insert the pink laboratory Seeger in the cast abutment and mount them on the analogue. Template to see the available space.

FITTING THE BRIDGE ON THE MODEL

The bridge, with the cast abutments and the white Seegers inserted are mounted onto the model above the O.T. Equator attachments, following the preplanned insertion line. Keeping it at an angle, the bridge is first of all inserted on the three O.T. Equator incisor attachments where it will remain lo-cked with the Seegers only. The crowns are compressed to fit on the abutments and put the bridge in place. This line of insertion, with the temporary cement inside the crown, should be respected even during the application of the bridge in the patient’s mouth. The temporary bridge allows the removal

of the bridge if necessary.

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PREROGATIVES AND ADVANTAGES COMPARED TO OTHER TECHNIQUES

FROM REMOVABLE TO FIXED PROSTHESIS IN A PRACTICAL AND ECONOMICAL WAY

Patients with lower removable prosthesis anchored to three external hexagonal im-plants with spherical attachments and three roots to extract.

The three roots have been extracted, an internal hexagonal implant is inserted in zone 43 onto which an O.T. Equator Titanium attachment is screwed.

The three spherical attachments of the three external hexagonal implants are removed. Three minimum height Titanium O.T. Equator attachments are screwed on.

The vertical and the centric dimensions in the patient’s mouth are marked, using the wax bite with a resin test plate. The models are mounted in the articulator in the laboratory. Teeth on wax are mounted on the same resin test plate which will be tested in the patient’s mouth with the stable plate inserted above the O.T. Equator

attachments.

LABORATORY

TRANSFORMATION OF A PROSTHESIS ON IMPLANTS

DENTAL PRACTICE: PRESENTATION OF A CASE

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O.T.Equator,attachment for internal

hexagon

O.T.Equator,attachment for external hexagon

TRANSFORMATION OF A PROSTHESIS ON THE IMPLANTS FROM A REMOVABLE PROSTHESIS

TO A FIXED TORONTO-TYPE PROSTHESIS Casting on the model, Seegers mounted inside the abutments. Finished prosthesis.

DENTAL PRACTICEFinal lower prosthesis. Temporary upper thread-reinforced-resin prosthesis wai-

ting for the incisor area to heal where the teeth have been extracted.

CONCLUSIONSThe chance of adapting the Titanium O.T. Equator attachments to every type of implant al-lows the opportunity to offer a patient who already wears a removable prosthesis, the chance to transform the removable prosthesis into a fixed prosthesis with a project that is both prac-tical and inexpensive. In the project described above, it was enough to add an implant (diffe-rent to the brand and model that already existed in the mouth) to create a balanced platform on which build a fixed prosthesis. In some cases, the project may also include the eventual

insertion of more implants.

BEFORE

AFTER

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After incisors extraction, Thread-Reinforced-Resin temporary bridge. Definitive lower proshtesis with composit teeth.

Dott. T.Grandi

TITANIUM O.T. EQUATOR ATTACHMENT COATED IN TiN FOR OVERDENTURE PROSTHESIS

FOR REMOVABLE PROSTHESIS ANCHORED TO ANY MODEL AND BRAND OF IMPLANTS

O.T. Equator is the smallest attachment currently available commercially. It is a rigid retention attachment and must be used according to the instructions. Because of its size, the O.T. Equator attachment is applicable to every removable resin prosthesis.

The Titanium O.T. Equator attachment with the retentive sphere coated in TiN has a protected surface with a hardness of more than 1600 Vickers. The O.T. Equator attachment is a rigid at-tachment without resilience. It is not indicated for use in cases of prostheses with a single attachment. Using the retention caps of various colours and retention inserted into the stainless steel container, the adjustment of the grip of the removable prosthesis in relation to the prosthetic case is achieved.

To obtain a resilient retention with the O.T. Equator attachment, use the O.T. Cap Normo from Rhein 83, preferably in pink, yellow or green inserted in the stainless steel containers that can also be found in the O.T. Implant price list (BONONIA IMPLANT SY-STEM).

Like all the attachments, even the O.T. Equators have their own particular characteristics. With the O.T. Equator attachment you get a minimal space. The O.T. Equator should be treated like a rigid precise attachment. To be certain you get a good functionality, it is advisable to fix the stainless steel containers with the caps inserted directly in the patient’s mouth using self-curing resin.

When the resin prostheses incorporate metal attachments inside them, these make them more fragile increasing the risk of breaka-ge. The O.T. Equator attachment (due to its low vertical size) can also be applied in cases of resin prosthesis with very low articula-tion and vertical dimensions with little risk of breakage.

It is possible to build a reinforced cast to be incorporated inside the resin prosthesis using the castable prefabricated O.T. Box large, with which you can model the reinfor-cement directly on the master mo-del without duplicating the coating. Even in prostheses with this cast reinforcement incorporated, it is possible to fix the stainless steel container with caps directly into the patient’s mouth.

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The O.T. Equator attachment presents ideal conditions to be used with success, whilst adhering to technical advice thanks to its size and reten-tion: it works well in all those prosthetic projects where a minimum of 3-4 implants form a tripod or a quadrilateral; in these cases the prosthesis will have a good stability and even the caps will have a much longer duration.

The attachment, including the container and the retentive caps, have a smaller size by a rigid retention. To make the O.T. Equator attachment take up less room, results of high retention although rigid were obtained. The choice of the O.T. Equator at-tachment should be made according to these characteristics. In cases of lower pro-sthesis with only two O.T. Equator attachments on two implants, near and aligned between them in the chin area, you may have problems when the patient chews on the molars.

When two O.T. Equator attachments are in the interforamina area, it is advisable to use a normal O.T cap from Rhein 83 to get a resilient retention which will offer the same hold but proves to be more resilient.

For hygienic reasons, you can close the square hole in the top of the sphere using the small closure screws or an elastic resinous light-curing cementum.

O.T. EQUATOR ATTACHMENTS ARE BUILT FOR EVERY MODEL AND BRAND OF IMPLANTS AVAILABLE COMMERICIALLY

Orders should be precise with the following in-formation provided:

- Model and brand of the implant- Diameter of the implant- Height of the abutment

Height from 0.5 to 7 mm for internal hexagon implantsHeight from 1.7 to 7 mm for external hexagon implants

Some implant brands are dispatched on the same day of order, whereas orders for les-ser known brands are dispatched within 3-4 days.

HOW TO ORDER O.T. EQUATOR ATTACHMENTS

The O.T. Equator attachments are also supplied in small quantities (two or three pieces) or in large series directly from the implant manufacturer.

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MINI-MEDIUM IMPLANTTITANIUM MONOBLOCK IMPLANTS WITH O.T. EQUATOR ATTACHMENT COATED IN TiN

The Mini-Medium implants are one-piece implants with a self-threading screw that enters smoothly into the bone. The design and the wide surface of the screws favour the primary seal. The TiN-coated O.T. Equator attachment has a surface hardness of 1600 Vickers.

The centre of gravity of the attachment at a gingi-val low level does not create lever play. Due to their shapes and sizes, these implants are not subject to breakage.

The range of caps with various holds allows you to manage the retention of the prosthesis. The O.T. Equator retentive caps should be used by always inserting them into the stainless steel housing. These caps have a rigid retention.

To get a resilient or cushioned retention you can use the O.T. Caps Normo, in a particular way in cases where the MiniMe-dium Implant is used as an immediate loading overdenture at-tachment. When you need to stabilize the patient’s old pros-thesis after surgery, it is appropriate to mount the very soft and resilient green O.T. Caps Normo in the first period (two or three months).

For hygienic reasons, you can close the square hole in the top of the sphere using the small closing screws or an elastic resinous light-curing cementum.

I M P L A N T S PACKAGING

AUTOCLAVABLE BURRS KIT

SURGICAL MANDREL

EXTENTION FOR SURGICAL MANDREL

AND RATCHET

RATCHET

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attachment ø 2,5mm

MINI-MEDIUM IMPLANTTHE MINI-MEDIUM IMPLANTS ARE IMPLANTS THAT DUE TO THEIR STRUCTURES FIND

VARIOUS APPLICATIONS

IMMEDIATE LOAD: COMBINED ELASTIC SEEGER BAR PROSTHESIS

Before surgery the mounting of the teeth on the wax base is tested. After surgery and after the insertion of four implants, the impression is taken. Correct the articulation reusing the wax bite with the marked data from the previous session. The wax in the gingival area of the articulation block is carved where the implants were inserted, which is then relined with soft wax heated in hot water. The cooled wax will give the exact position on the new plaster model.

In the wax bite the side edges are reduced until you find the support of only the alveolar ridge (which never changes and is always the same in every model). The new model is remounted in the articulator in its exact position. The resin prosthesis can be finished without any errors of articulation.

Bar structure modelled using spherical O.T. Cap castable at-tachments linked with self-curing resin.The modelled castable structure is insulated (with a new system) using a 0.2 mm leaf of Teflon to allow the construction of the overstructure with castable components above it contempo-raneously. Structure and overstructure prepared

for melting. Casting sandblasted, fini-shed and polished. With this system you obtain casts with balanced expansions and save time on work and save ma-terials. Bar structure on the model, the cast and varnished overstructure, resin teeth remounted using the silicon tem-plate.

In contrast to the fixed immediate load prosthesis that receive the loads only in the direction of the occlusal plane, these combined removable prosthesis are also stressed in the opposite

direction when the patient removes the removable prosthesis for cleaning.Finished prosthesis in the patient’s mouth. In the early days, to avoid or reduce traumatic injuri-es inverse to the chewing load, very resilient green O.T Caps have to be mounted in the remova-ble prosthesis and the patient was advised to remove the prosthesis once a day. For a certain

time, the patient was prescribed a diet of soft foods.

To lock the bar above the implants insert the Seegers (from the side shown) and tighten the Titanium sealing lids.

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CHECK THE DVD FOR MORE DETAILED INFORMATION

PROMOTIONAL PACKAGING SURGERY-LABORATORY-SURGERY KIT

S.L.S. KIT COMBINED ELASTIC SEEGER BAR PROSTHESIS IMMEDIATE LOAD IN 24-72 HOURS

Surgical guided protocol to rehabilitate an edentulous patientfrom the implant insertion to the prosthesis

The S.L.S kit contains a range of components and ac-cessories to build and finish the prosthesis, without any confusion in three sessions (in 24 – 48 hours).To apply the system, the dentist needs to order four MINI-MEDIUM IMPLANTS specifying the diameter and length. Alternatively, the dentist can use four im-plants of any kind and brand available commercially and apply the custom built O.T. Equator attachments supplied along with the S.L.S kit. In this second case, if the dentist operates on implants normally used, he already has all the necessary surgical instruments.

The locking of the bar above the im-plants is done in a passive way, even on widely divergent implants, thanks to the Elastic Seeger locking system. Please note: these Seegers (without handles) have an insertion direction as shown in the drawing; they do not work when used in the opposite di-rection.

With this kit you will have an Elastic Seeger Bar prosthesis in an organized way (as shown on the previous page).

In the light Blue S.L.S Kit there are the components to build the multi-use O.T. Bar structure.

In the Blue S.L.S Kit the-re are the components to build the bar structure with the O.T. Cap sphere.

Castable O.T. Equator attachments are also available to build cast bar structures. On these attachments, once cast, the O.T. Equator retention caps are mounted (to get a good function, they should always be inserted in the prefabricated stainless steel containers to be incorporated into the resin or eventually also to be welded to the cast overstructure).

CASTABLE O.T. EQUATOR ATTACHMENTS

33

Dott. G.Vaccaro

OVERDENTURE ROOTSTITANIUM O.T. EQUATOR PIVOT WITH TiN COATING

ø 1,

8 m

m H

10

mm

ø 1,

7 m

m H

9 m

m

ø 1,

4 m

m H

7 m

mTitanium O.T. Equator pivot + TiN is a direct overden-ture attachment for roots. Its small size allows you to stabilize removable prostheses in cases where there are reduced vertical spaces.

In the hole on the top of the attachment all the B.I.S. components can be screwed. In special cases, there is the possibility of designing ELASTIC SEEGER connection bars between more roots, or MINI-MEDIO IMPLANTS and roots in a simple and pas-sive way.

The O.T. Equator Titanium root canal posts coated in TiN should be fixed with a perma-nent cement (preferably composites) in ro-ots lowered at the gums level. To calibrate the canal, Mooser type burrs can be used.

The range of retention caps offers varying de-grees of elasticity and allows you to manage the retention of the removable prosthesis according to the number of attachments and the state of health of the roots.To get a resilient retention with the O.T. Equa-tor attachment use the Normo O.T. Caps from Rhein 83, preferably in pink or yellow, inserted into the stainless steel containers that are found in the O.T. Implant price list.(BONONIA IMPLANT SYSTEM).

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Special thanks for provided clinical images to:Prof. S.Bortolini

Prof. A.NataliProf. M.Cirulli

Dott. G. VaccaroDott. T. Grandi

Dott. P. Angelini

Dott. G.Vaccaro

REF. KF

REF. MU35

REF. FP152

REF. FC19

REF. FC24

REF. M27

REF. M32

REF. B08

REF. B11

REF. B13

REF. B15

REF. CHC

REF. SCCK

REF. IM2708REF. IM2711REF. IM2713REF. IM2715

REF. IM3208REF. IM3211REF. IM3213REF. IM3215

REF. KRK

REF. TTVL

REF. TP2

REF. TPM2

REF. TPIQ2

REF. AI412REF. AI502

ø MM 4 REF. CMCø MM 5 REF. CM50C

ø MM 3,5 REF. CMTGLø MM 4 REF. CM40GLø MM 5 REF. CM50GL

REF. CMTFP

REF. SRM6

REF. SM6

REF. SBS6

REF. SRL6

REF. ACSES

REF.CMTB30FP

H 3 mm

H 1,8 mm

REF. STI

REF. VC

REF. VXL

REF. BCC2

REF. BOBL

ø MM 4 REF. MT40GL

REF. TCV

ø MM 3.5 REF. MTGL

ø MM 5 REF. MT50GL

ø MM 4 REF. MTSF

ø MM 4 REF. MCø MM 5 REF. M50C

REF. MBSQC

H

H

REF. CI2

REF. CBST4REF. CVF4

REF. CRS4

REF. CGE4

REF. CNL4

REF. P1810REF. P1709REF. P1407

REF. CC2D

REF. FM79

REF. ATT

REF. AT

REF. KA42

REF. FM910

REF. ACATT

REF. VPC

REF. CNI3

REF. CNBST6

REF. CNVE6

REF. CNRS6

REF. CNGE6

REF. AT-C2

REF. KPN

35

ø MM 3,5 REF. MTSEGø MM 4 REF. MT40SEGø MM 5 REF. MT50SEG

REF. KQC125

REF. KQ125

REF. MBI

REF. SIDC

REF. SICS

REF. FSS

REF. ASSE

ACCESORIES FOR USE WITH UNIVERSAL BLUE HANDLE

RETENTIVE CAPS O.T. CAP NORMO

RETENTIVE CAPS O.T. CAP MICRO

TEAR-OFF IMPRESSION TRANSER

STAINLESS STEEL ACCESORIES

TEAR-OFF IMPRESSION TRANSER

AVAILABLE ON REQUEST- catalogue- instruction manual- price list- program of monthly prosthesis courses based in Bologna for dentists and dental technicians- BONONIA IMPLANT SYSTEM DVD video -Periodic technical updates DVD video (only for those who have attended the course)

Technical information and telephone support0514208111

Fax: 0514214884e-mail: info@otimplant.com

www.otdentalstudio-implant.com

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