Porcelain Fused to Metal - Bicon Dental · PDF file3 Direct Abutment Level Impression of a Modified Abutment At the time of implant uncovering, place a non-shouldered abutment and

Technique ManualNon-Shouldered Abutment

Porcelain Fused to Metal

1

Temporization with Emergence Cuff

Choose the widest abutment that supports but does not encroach upon the interdental papillae and whose height can satisfy all occlusal considerations. Seat the abutment with its corresponding emergence cuff into the implant well. Abutment diameter dictates the diameter of the emergence cuff.

Choose emergenCe Cuff1

Incorporate the emergence cuff into the transitional crown such that it becomes the apical third of the transitional crown. The circumferential groove on the emergence cuff allows the transitional crown material to mechanically lock to the emergence cuff. The emergence cuff may be easily modified to achieve a desired sulcus contour. Trim and polish the transitional crown prior to cementing it to the abutment with temporary cement.

TrAnsiTionAl Crown2

Remove the transitional crown with the emergence cuff before making the final impression.

heAled sulCus4

Allow the soft tissue to mature for at least 6 weeks after a stage two surgical uncovering prior to making an impression.

mATure Tissue3

4.0

x 6.

5

4.0mm

5.0

x 6.

5

5.0mm6.

5 x

6.5

6.5mm

2

Impression Making and Cementationof an Unmodified Abutment

The diameter of the abutment is measured at the widest part of the abutment. The height of the non-shouldered abutment is measured from the widest portion to the occlusal aspect of the abutment. The abutment post height is constant and is not variable.

Make a direct impression of the modified or unmodified abutment and pour a conventional stone model. The laboratory procedures are the same as for the fabrication of a crown or fixed bridge for a natural tooth.

mAke impression 5

After any needed occlusal, interproximal, or aesthetic contouring, cement the crown conventionally with minimal cement at the cervical aspect of the crown to avoid adverse hydraulic forces. Care must be taken to remove all extraneous cement.

CemenT Crown6

The design of the Bicon non-shouldered abutment system is such that the hemispherical base of the abutment does not sit flush with the neck of the implant. By design, there is a space below the abutment post when the abutment is fully seated. When viewing this on a radiograph, it can be seen as a radiolucency. please note that the post of any abutment may not be modified. Altering the abutment post in any manner or using a cementing medium will affect the frictional fit of the locking taper resulting in a potentially non-retentive abutment.

3 Measurement Guide

non-shouldered Abutment 2.0mm Post

non-shouldered Abutment 3.0mm Post

Diameter

Hei

ght

AbutmentPost Height

Diameter

AbutmentPost Height

Hei

ght

3

Direct Abutment Level Impressionof a Modified Abutment

At the time of implant uncovering, place a non-shouldered abutment and allow the soft tissue to heal around the hemispherical base of the abutment for 6 weeks. Choose the widest non-shouldered abutment that will support the interdental papillae without encroaching upon them.

plACe AbuTmenT1

Use a sharp #1557 carbide bur to modify the abutment, if necessary. use irrigation when preparing the abutments intra-orally to prevent heating and potential damage to the bone.

modify AbuTmenT (opTionAl)2

A try-in of the casting prior to the porcelain application is advised to assure a passive seating.

Try-in CAsTing4

Make a direct impression of the modified or unmodified abutment with conventional impression materials and pour a conventional stone model. The laboratory procedures are the same as for the fabrication of crowns or fixed bridges for natural teeth. use a knife or feathered edge margin.

mAke impression3

4

■ Choose the widest abutment to accommodate the edentulous space without encroaching upon the interdental papillae.

■ 3.5mm abutments are recommended only for mandibular incisors; 4.0mm abutments are primarily used for maxillary laterals and bicuspids; 5.0mm abutments are more universal in their use; 6.5mm and 7.5mm abutments are ideally suited for molars.

■ The abutment can rotate 360˚ to reach a desired position or to achieve parallelism prior to seating. ■ Avoid direct handling of an abutment post, since a change of its geometry may result in a non-retentive abutment.

■ Use an abutment preparation holder (260-101-390) when modifying abutments extra-orally. ■ Use irrigation when preparing an abutment intra-orally. ■ Do not make an impression with the emergence cuff. ■ The use of retraction cord is not necessary. ■ An emergence cuff can act as a means of gingival retraction. ■ The casting may end with a knife or feathered edge margin anywhere along the coronal aspect of the abutment.

■ Use minimal amount of cement at the cervical margin to avoid hydraulic forces which may prevent the crown from seating fully.

3 keys to success

Cementation of a Modified Abutment

After any needed occlusal, interproximal, or aesthetic contouring, cement the crown conventionally with minimal cement only at the cervical aspect of the crown to avoid adverse hydraulic forces. Care must be taken to remove all extraneous cement.

Crown5

Recheck the occlusion after cementation.

reCheCk oCClusion6

Note: Use irrigation when preparing the abutment intra-orally to prevent heating and potential damage to the bone.A try-in of the casting prior to the porcelain application is advised to assure a passive seating.A knife or feathered-edge margin is employed at the most apical portion of the die. The margin need not be at the abutment’s height of contour.Statistically, a 2.0mm diameter abutment post will move 0.1mm into the well of an implant from its initial insertion to its being definitively seated, and a 3.0mm abutment will move 0.25mm.

5

Temporization of an Unmodified Abutment with an Acrylic Sleeve*

Note: Statistically, a 2.0mm diameter abutment post will move 0.1mm into the well of an implant from its initialinsertion to its being definitively seated, and a 3.0mm abutment will move 0.25mm.

*See pages 13 and 14 for prosthetic components.

Insert the appropriate non-shouldered abutment. The diameter of the abutment is dictated by the anatomy of the interdental papillae. The abutment should support the papillae without encroaching upon them.

inserT AbuTmenT1

Tap the abutment in the long axis of the abutment post and implant well.

seAT AbuTmenT2

Confirm the appropriateness of the non-shouldered acrylic temporization sleeve with a vacuum formed template. Adjust the acrylic sleeve as necessary.

Confirm AppropriATeness4

Orientate the internal flat(s) of the appropriate non-shouldered acrylic temporization sleeve with the external flat(s) of the abutment prior to snapping it onto the abutment.

snAp onTemporizATion sleeve3

6

Remove transitional prosthesis for polishing.

Snap the completed transitional prosthesis onto the non-shouldered abutment to facilitate the formation and preservation of an aesthetic soft tissue emergence profile.

■ Choose the widest abutment and sleeve that will support the interdental papillae without encroaching upon them.

■ Always confirm the complete seating of a snap-on acrylic sleeve for both the non-shouldered abutment and colored abutment transfer die.

■ Avoid the use of excessive transitional material intra-orally, since it is usually easier to add to a void than it is to remove excess material.

3 keys to success

Inject transitional material into the vacuum-formed template prior to re-inserting it over the non-shouldered acrylic temporization sleeve to form a transitional prosthesis.

Inject transitional crown material around the non-shouldered acrylic temporization sleeve.



polishTrAnsiTionAl prosThesis7 snAp on

TrAnsiTionAl prosThesis8

injeCTTrAnsiTionAl mATeriAl5 form

TrAnsiTionAl prosThesis6

7


Note: Statistically, a 2.0mm diameter abutment post will move 0.1mm into the well of an implant from its initialinsertion to its being definitively seated, and a 3.0mm abutment will move 0.25mm.



inserT AbuTmenT1


seAT AbuTmenT2

Add transitional material to a modified or unmodified sleeve.

Add TrAnsiTionAl mATeriAl4

Orientate the internal flat(s) of the appropriate non-shouldered acrylic temporization sleeve with the external flat(s) of the abutment prior to snapping it onto the abutment.

snAp onTemporizATion sleeve3

8

■ It is paramount that the proper abutment transfer die height be chosen to pour the stone model since all transfer dies of the same color will snap into the impression sleeve of that color.

■ The diameter and height of the transfer dies are sized to match the diameter and height of the abutments.

■ Avoid making an impression with the tooth colored temporization sleeve, since they are not color coded with the transfer dies and are more retentive.

3 keys to success


Wait for soft tissue healing.

wAiT for heAling5

Make an indirect abutment level transfer impression by injecting impression material around the non-shouldered impression sleeve and abutment.

mAke AbuTmenTTrAnsfer impression

mAke AbuTmenTTrAnsfer impression6


9

Impression of an Occlusally ModifiedAbutment with an Acrylic Sleeve*



inserT AbuTmenT1


seAT AbuTmenT2

After the necessary modifications have been made, orientate the internal flat(s) of the appropriate non-shouldered colored acrylic impression sleeve with the external flat(s) of the abutment prior to snapping it onto the abutment.

snAp-on sleeves4

Evaluate the occlusal height of the abutment and trim as necessary with a sharp carbide bur and external irrigation.

modify As neCessAry3

10

■ If an abutment must be modified occlusally, a corrective coping must be made for the modification of the laboratory transfer die. Without the fabrication of a corrective coping the final casting will not accurately fit the modified abutment.

■ If the margin must be modified chairside, it is recommended to make a direct impression of the abutment.

■ It is recommended that any modifications be made by the laboratory technician for greater accuracy.

3 keys to success

Note: Statistically, a 2.0mm diameter abutment post will move 0.1mm into the well of an implant from its initial insertion to its being definitively seated, and a 3.0mm abutment will move 0.25mm.


Trim the impression sleeve to the level of the modified abutment. Trim a second impression sleeve to the level of the modified abutment to act as a corrective coping for the modification of the laboratory abutment transfer die.

modify impression sleeves5

Impression of an Occlusally ModifiedAbutment with an Acrylic Sleeve*

11

Laboratory TechniqueCrown Fabrication with an Acrylic Sleeve*

Orientate the external flat(s) of the colored abutment transfer die with the internal flat(s) of the correspondingly colored non-shouldered acrylic impression sleeve prior to snapping it into the impression. it is imperative that the correct abutment transfer die be used. The diameter and height of the transfer die should match the diameter and height of the abutment.

Pour a soft tissue or stone model.

fAbriCATe model2

Snap a correspondingly colored impression sleeve or a temporization sleeve onto the colored abutment transfer die. Make any necessary adjustments to the waxing sleeve and/or abutment transfer die.

snAp on sleeves3a modify sleeves3b

Make a corrective coping using an impression or temporization sleeve.

unCover implAnTsmAke CorreCTive Coping4

Incorporate the waxing sleeve into the wax pattern for the metal casting to be used intra-orally to modify the seated titanium abutment.

wAxing5

inserT AbuTmenTTrAnsfer die1


12*See pages 13 and 14 for prosthetic components.

■ It is paramount that the proper abutment transfer die height be chosen to pour the stone model since all transfer dies of the same color will snap into the impression sleeve of that color.

■ The diameter and height of the transfer dies are sized to match the diameter and height of the abutments.

■ Impression sleeves and temporization sleeves of the same diameter are interchangeable for laboratory purposes only.

■ The temporization sleeves are more retentive than the impression sleeves.

3 keys to success

Try-in metal casting for a passive fit after having used a corrective coping to make any necessary modifications.

Try-in CAsTing6

Apply porcelain following normal layering techniques until the crown is completed.

porCelAin AppliCATion7

Final view of cemented porcelain fused to metal restoration.

finAl Crowns8

Laboratory TechniqueCrown Fabrication with an Acrylic Sleeve*

13

Non-Shouldered AbutmentAbutment Selection Guide

Abutment Selection Board Part # 260-101-037 (Plastic Abutments Included)

Designed to be used by a laboratory technician to facilitate the selection of the appropriate abutment size. The components on the board may not be used for impressions or any other laboratory procedures.

3.5mm Diameter 4.0mm Diameter 5.0mm Diameter 6.5mm Diameter 7.5mm Diameter0˚ 15˚ 25˚ 0˚ 15˚ 25˚ 0˚ 15˚ 0˚ 15˚ 0˚ 15˚ 25˚ 0˚ 15˚ 0˚ 15˚ 0˚ 15˚ 0˚ 15˚ 0˚ 15˚

3.5 x 6.5 0˚260-135-001

3.5 x 6.5 15˚260-135-015

3.5 x 6.5 25˚260-135-025

4.0 x 6.5 0˚260-140-002

4.0 x 6.5 15˚260-140-015

4.0 x 6.5 25˚260-140-025

4.0 x 10 0˚260-140-101

4.0 x 10 15˚260-140-115

5.0 x 5.0 0˚260-150-050

5.0 x 5.0 15˚260-150-055

5.0 x 6.5 0˚260-150-001

5.0 x 6.5 15˚260-150-015

5.0 x 6.5 25˚260-150-025

5.0 x 10 0˚260-150-101

5.0 x 10 15˚260-150-115

5.0 x 12 0˚260-150-201

5.0 x 12 15˚260-150-215

6.5 x 5.0 0˚260-165-050

6.5 x 5.0 15˚260-165-055

4.0 x 6.5 0˚260-340-001

4.0 x 6.5 15˚260-340-015

4.0 x 10 0˚260-340-101

4.0 x 10 15˚260-340-115

5.0 x 5.0 0˚260-350-050

5.0 x 5.0 15˚260-350-055

5.0 x 6.5 0˚260-350-001

5.0 x 6.5 15˚260-350-015

5.0 x 6.5 25˚260-350-025

5.0 x 10 0˚260-350-101

5.0 x 10 15˚260-350-115

5.0 x 12 0˚260-350-201

5.0 x 12 15˚260-350-215

6.5 x 5.0 0˚260-365-050

6.5 x 5.0 15˚260-365-055

6.5 x 6.5 0˚260-365-001

6.5 x 6.5 15˚260-365-015

7.5 x 8.0 0˚260-375-801

7.5 x 8.0 15˚260-375-815

3.5 x 6.5mm260-135-465

4.0 x 6.5mm260-140-465

4.0 x 10mm260-140-410

5.0 x 5.0mm260-150-450

5.0 x 6.5mm260-150-465

5.0 x 10mm260-150-410

5.0 x 12mm260-150-412

6.5 x 5.0mm 260-165-450

6.5 x 6.5mm260-165-465

7.5 x 8.0mm260-175-480

3.5mm260-135-165

4.0mm260-140-165

5.0mm260-150-165

5.0mm260-150-165

6.5mm260-165-165

7.5mm260-175-165

12.0mm

10.0mm

6.5mm

5.0mm

12.0mm

Top of Implant

Top of Implant

10.0mm

8.0mm

6.5mm

5.0mm

12.0mm

10.0mm

8.0mm

6.5mm

5.0mm

2.0mm Post

Restorative/Laboratory Kit

3.0mm Post

Temporization Sleeve (2)

12.0

mm

12.0

mm

12.0

mm

3.0mm

2.5mm

14

Note: Snap-on sleeves are only specific for abutment diameter. Abutmentheight is not a criterion for proper selection of snap-on sleeves. Transferdies correspond to exact diameter and height of abutment placed.

Because of machining tolerances, acrylic sleeves may not reach theheight of contour for some angled abutments.

3.5mm Diameter 4.0mm Diameter 5.0mm Diameter 6.5mm Diameter 7.5mm Diameter0˚ 15˚ 25˚ 0˚ 15˚ 25˚ 0˚ 15˚ 0˚ 15˚ 0˚ 15˚ 25˚ 0˚ 15˚ 0˚ 15˚ 0˚ 15˚ 0˚ 15˚ 0˚ 15˚

3.5 x 6.5 0˚260-135-001

3.5 x 6.5 15˚260-135-015

3.5 x 6.5 25˚260-135-025

4.0 x 6.5 0˚260-140-002

4.0 x 6.5 15˚260-140-015

4.0 x 6.5 25˚260-140-025

4.0 x 10 0˚260-140-101

4.0 x 10 15˚260-140-115

5.0 x 5.0 0˚260-150-050

5.0 x 5.0 15˚260-150-055

5.0 x 6.5 0˚260-150-001

5.0 x 6.5 15˚260-150-015

5.0 x 6.5 25˚260-150-025

5.0 x 10 0˚260-150-101

5.0 x 10 15˚260-150-115

5.0 x 12 0˚260-150-201

5.0 x 12 15˚260-150-215

6.5 x 5.0 0˚260-165-050

6.5 x 5.0 15˚260-165-055

4.0 x 6.5 0˚260-340-001

4.0 x 6.5 15˚260-340-015

4.0 x 10 0˚260-340-101

4.0 x 10 15˚260-340-115

5.0 x 5.0 0˚260-350-050

5.0 x 5.0 15˚260-350-055

5.0 x 6.5 0˚260-350-001

5.0 x 6.5 15˚260-350-015

5.0 x 6.5 25˚260-350-025

5.0 x 10 0˚260-350-101

5.0 x 10 15˚260-350-115

5.0 x 12 0˚260-350-201

5.0 x 12 15˚260-350-215

6.5 x 5.0 0˚260-365-050

6.5 x 5.0 15˚260-365-055

6.5 x 6.5 0˚260-365-001

6.5 x 6.5 15˚260-365-015

7.5 x 8.0 0˚260-375-801

7.5 x 8.0 15˚260-375-815

3.5 x 6.5mm260-135-465

4.0 x 6.5mm260-140-465

4.0 x 10mm260-140-410

5.0 x 5.0mm260-150-450

5.0 x 6.5mm260-150-465

5.0 x 10mm260-150-410

5.0 x 12mm260-150-412

6.5 x 5.0mm 260-165-450

6.5 x 6.5mm260-165-465

7.5 x 8.0mm260-175-480

3.5mm260-135-165

4.0mm260-140-165

5.0mm260-150-165

5.0mm260-150-165

6.5mm260-165-165

7.5mm260-175-165

Top of Implant

Top of Implant

12.0mm

10.0mm

6.5mm

5.0mm

12.0mm

10.0mm

8.0mm

6.5mm

5.0mm

12.0mm

10.0mm

8.0mm

6.5mm

5.0mm

2.0mm Post

Restorative/Laboratory Kit

3.0mm Post

Temporization Sleeve (2)

12.0mm

12.0mm

12.0mm

3.0mm

2.5mm

15

Temporary and Healing Abutments

Note: Select a temporary or healing abutment that is of a sufficient size and shape to laterally support theinterdental papillae, but will not encroach upon the papillae.

At the time of uncovering, place a titanium temporary abutment or a plastic healing abutment. These abutments will support the soft tissue and assist in the formation of the gingival sulcus. Either abutment may be modified to achieve a desired gingival contour. Temporary or transitional crowns should not be placed on temporary or healing abutments.

TemporAry AbuTmenTs1a heAling AbuTmenT1b

TemporAry AbuTmenT heAling AbuTmenT

16

Implant Level Impression

Note: An implant level impression provides the opportunity for selection and modification of the abutment atthe laboratory as well as for the extra-oral cementation of the crown.

Insert a green 3.0mm titanium impression post into the implant well, using finger pressure.

inserT green impression posT1

Insert a red 2.0mm titanium impression post into the implant well, using finger pressure.

inserT red impression posT2

Snap a 3.0mm plastic impression sleeve onto a corresponding 3.0mm titanium impression post.

snAp on impression sleeve3

Snap a 2.0mm plastic impression sleeve onto a corresponding 2.0mm titanium impression post.

snAp on impression sleeve4

Inject impression material around plastic impression sleeves and make impression.

injeCT impression mATeriAl5

After making impression, plastic impression sleeves should be withdrawn within the impression while titanium posts remain in the implant well.

wiThdrAw impression & sleeves6

Remove titanium posts from the implant well and assemble to a corresponding titanium implant analog.

Assemble TiTAnium posTs & AnAlogs7

Insert assembled unit into the impression.

inserT Assembly inTo impression8

Pour a stone model.

pour A sTone model9

17

Extra-Oral Cementation

Non-Shouldered AbutmentCementation

After the crown has been fabricated and checked for color and morphology, extra-orally cement the abutment and crown. Tap the abutment-crown unit into the well of the implant.

Cemented restoration.

CemenT prosThesis4

Cement prosthesis conventionally with only a minimal amount of any type of cement at the cervical margin.

CemenT prosThesis3

Cementation

exTrA-orAlly CemenT AbuTmenT And Crown1 exTrA-orAlly CemenT

AbuTmenT And Crown2

18

Non-Shouldered AbutmentPFM Flowchart

Method ofImpression

ImpressionProduct Needed

TemporizationProduct Needed

Laboratory Product Needed

Non-Shouldered Abutment

Final Crown

None

Abutment Transfer Dieand Acrylic Sleeve

for Non-Shouldered Abutment

Non-ShoulderedAbutment

Emergence Cuff or Temporization Sleevefor Non-Shouldered

Abutment

Temporization Sleevefor Non-Shouldered

Abutment

Temporary or HealingAbutment and/or

Transitional Crown

NoneImpression Sleeve

for Non-Shouldered Abutment

Implant LevelImpression Kit

DirectAbutment Level

IndirectAbutment Level Implant Level

PFM

Copyright © 2008 Bicon LIT-250 R1208

WORLD HEADQUARTERS501 Arborwayboston, mA 02130 usAtel: 800.88.biCon u 617.524.4443fax: 800.28.biCon u 617.524.0096web: www.bicon.come-mail: [email protected]

Documents

Porcelain Fused to Metal - Bicon Dental · PDF file3 Direct Abutment Level Impression of a Modified Abutment At the time of implant uncovering, place a non-shouldered abutment and