INDEX [microdentsystem.com] · INTRODUCTION REMOVABLE AND IMMEDIATE . PROSTHESIS MULTIPLE...
Transcript of INDEX [microdentsystem.com] · INTRODUCTION REMOVABLE AND IMMEDIATE . PROSTHESIS MULTIPLE...
INDEX
PRESENTATION
INTRODUCTION
REMOVABLE AND IMMEDIATE PROSTHESIS
MULTIPLE PROSTHESIS
CEMENTED PROSTHESISMicrodent Genius conical (straight) abutment or Microdent Genius angled abutment
SINGLE PROSTHESIS
Pag. 05
Pag. 06
Pag. 06
Pag. 10
Pag. 11
Pag. 08
Pag. 09
LABORATORY MANUAL
MICRODENT GENIUS CONICAL (STRAIGHT) ABUTMENT WITH FLAP
SINGLE PROSTHESIS
MICRODENT GENIUS CONICAL (STRAIGHT) ABUTMENT WITHOUT FLAP
MICRODENT GENIUS IMMEDIATE LOADING CONICAL (STRAIGHT) ABUTMENT
MICRODENT GENIUS ANGLED ABUTMENT
MICRODENT GENIUS CIRCULAR MINI CAPITEL ABUTMENT
MICRODENT GENIUS ANGLED MINI CAPITEL ABUTMENT
MICRODENT GENIUS OSSCILIA RETENTION ABUTMENT
WARNINGS
Impression taking (open tray)
Casting and preparation of models
REMOVABLE PROSTHESISMicrodent Genius Osscilia retention abutment Pag. 23
Planning and preparation of the pa-tient for surgery
Planning and preparation of the patient for surgery.
Impression taking (open tray)
Impression taking (open tray)
Casting and preparation of models
Casting and preparation of models
Prosthesis finishing
Prosthesis finishing
Teeth test
Teeth test
Complete prosthesis finishing and copy
Abutment preparation
CEMENT-SCREWED PROSTHESISMicrodent Genius Mini Capitelabutment - Bars for hybrids
Pag. 31
Pag. 31
Pag. 31
Pag. 31
Pag. 16
MULTIPLE PROSTHESIS
MULTIPLE CEMENT-SCREWED PROSTHESIS
HYBRID CEMENT-SCREWED PROSTHESIS
INSTRUCTIONS FOR USE
MRI SAFETY INFORMATION
SURGICAL INSTRUMENTS
GUARANTEE PROGRAM
Impression taking (open tray)
Casting and preparation of models
Planning and preparation of the pa-tient for surgery
Planning and preparation of the patient for surgery.
Abutment preparation
Drill types
Sub-structure confection
Ceramic loading
Abutment preparation
Drill types
Sub-structure confection
Ceramic loading
Casting and preparation of models
Casting and preparation of models
Impression taking (open tray)
Abutment preparation
Abutment preparation
Prosthesis finishing
Ceramic loading
Teeth test
Impression taking (open tray)
REMOVABLE PROSTHESISMicrodent Genius Mini Capitel abutment Pag. 27
PRESENTATION
Implant Microdent System S.L. is a company that, from its creation in 1983, has specialized in developing, manufacturing and marketing components for odontological treatments, and, specially, oral implantology.
Always striving for customer satisfaction, Microdent offers all the guarantee, both of quality and service, backed up by its long and ascending professional history in the field of oral implantology.
The periodical offer of formation courses for professionals of the implantology field and the existence of a collaboration and assessment team allows Microdent to have products that verify the most strict quality parameters stablished, as well as to satisfy the needs of its clients.
Microdent has modern facilities equipped with the most cutting-edge technology, thus making Microdent into one of the pioneer companies in the research and manufacture of solutions for oral implantology. The patents obtained by Microdent products demonstrate the continued dedication of the company to the research work.
MICRODENT GENIUS LABORATORY MANUAL 5
INTRODUCTION
LABORATORY MANUAL
This manual informs odontologists and prosthetists of the different Microdent Implant System trademark products available to make a dental prosthesis. It also includes a short description of the recommended protocols to follow to make the prosthesis.
This manual is provided for information only. Whether to use these protocols or not is left to the discretion and responsibility of the odontologist or prosthetist.
The use of the strict protocols described in this manual guarantees the efficacy of the Micro-dent products.
Microdent Genius With ribbed cone internal connection
WARNINGS
MICRODENT GENIUS CONICAL (STRAIGHT) ABUTMENT WITH FLAP
• A retention screw is provided in the container with the abutment. • Do not exceed a torque of 30 Ncm for the final fixation of the abutment. Through laboratory trials, a screwed torque of 10 / 15 Ncm was found to be recommended.• The abutment cut cannot be larger than 4.5 mm measured from the upper part of the abutment. • While the abutment width must not be modified, its height can be customized. A minimum length of 4.50 mm is required in order to cement the prosthesis.• Use the GNLLDS extraction key to remove the abutment from the implant.
MICRODENT GENIUS CONICAL (STRAIGHT) ABUTMENT WITHOUT FLAP
• A retention screw is provided in the container with the abutment. • Do not exceed a torque of 30 Ncm for the final fixation of the abutment. Through laboratory trials, a screwed torque of 10 / 15 Ncm was found to be recommended.
MICRODENT GENIUS LABORATORY MANUAL6
• The abutment cut cannot be larger than 4.5 mm measured from the upper part of the abutment.• While the abutment width must not be modified, its height can be customized. A minimum length of 4.50 mm is required in order to cement the prosthesis.
MICRODENT GENIUS IMMEDIATE LOADING CONICAL (STRAIGHT) ABUTMENT• A retention screw is provided in the container with the abutment. • Do not exceed a torque of 30 Ncm for the final fixation of the abutment. Through laboratory trials, a screwed torque of 10 / 15 Ncm was found to be recommended.• The abutment cut cannot be larger than 4.5 mm measured from the upper part of the abutment. • While the abutment width must not be modified, its height can be customized. A minimum length of 4.50 mm is required in order to cement the prosthesis.
MICRODENT GENIUS ANGLED ABUTMENT• A retention screw is provided in the container with the abutment..• Not to exceed 30 Ncm to torque for the final fixation of the abutment. Through lab trials, a screwed torque of 10 / 15 Ncm was found to be recommended.• The abutment cannot be modified.• Angled abutments are not recommended for the posterior region of the mouth.
MICRODENT GENIUS CIRCULAR MINI CAPITEL ABUTMENT• Use the UTSNLEC key to screw the abutment and the implant together.• Do not exceed a torque of 30 Ncm for the final fixation of the abutment. Through laboratory trials, a screwed torque of 10 / 15 Ncm was found to be recommended.
MICRODENT GENIUS ANGLED MINI CAPITEL ABUTMENT• The UTSNATR18 retention screw and the PACN carrier are provided in the container with the Mini Capitel angled abutment.• Use the PACN carrier to fix Mini Capitel angled abutment to its desired position.• Do not exceed a torque of 30 Ncm for the final fixation of the abutment. Through laboratory trials, a screwed torque of 10 / 15 Ncm was found to be recommended.
MICRODENT GENIUS OSSCILIA RETENTION ABUTMENT
• The use of the hex. 1.20 screwdriver is required to join the product and the implant together.• Do not exceed a torque of 30 Ncm for the final fixation of the abutment.• Do not exceed a disparallelism of 17º between implants.• The exchange of retainers is facilitated through the use of the MC220PB screwdriver.• The retainers are identified by color. The different colors denote different retentive strengths. - Black retainer = soft retention strength 2Kg. For use in laboratory trials. - White retainer = middle retention strength 3Kg. To keep stable for a long period of time. - Red retainer = strong retention strength 4Kg. Only to be used in special cases
where an extreme fixation is required.
MICRODENT GENIUS LABORATORY MANUAL
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SINGLE PROSTHESIS
CONICAL ABUTMENT WITH FLAP
ANGLED ABUTMENT WITH FLAP
CONICAL ABUTMENT WITHOUT FLAP
ANGLED ABUTMENT WITHOUT FLAP
(*)SCREWDRIVERS(DL120)
(*) Screwdriver liable to change to DC120, MH120 or SUH120RL depending on the case
CONICAL OR ANGLED
ABUTMENT
CEMENTED
SCREWDRIVERS
MICRODENT GENIUS LABORATORY MANUAL8
MULTIPLE PROSTHESIS
CONICAL ABUTMENT WITH FLAP
MINI CAPITEL ABUTMENT
MINI CAPITEL ABUTMENT
ANGLED ABUTMENT WITH FLAP
ANGLED MINI CAPITELABUTMENT
ANGLED MINI CAPITELABUTMENT
CONICAL ABUTMENT WITHOUT FLAP
RETENTION SCREWPROSTHESIS UTSNTR
RETENTION SCREWPROSTHESIS UTSNTR
ABUTMENTAPPLICATOR
ABUTMENTAPPLICATOR
ANGLED ABUTMENT WITHOUT FLAP
RETENTION SCREW PROS-THESIS UTSNATR18
RETENTION SCREW PROS-THESIS UTSNATR18
CARRIER PACN
CARRIER PACN
CEMENTABLEABUTMENT
CEMENTABLEABUTMENT
(*)SCREWDRIVERSDL120
(*) Screwdriver liable to change to DC120, MH120 or SUH120RL depending on the case
CEMENTED
CEMENT-SCREWED
CONICAL OR ANGLED
ABUTMENT
MINI CAPITEL ABUTMENT
MINI CAPITEL ABUTMENT
HYBRID (BARS)CEMENT-SCREWED
PROSTHESIS
SCREWDRIVERS
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REMOVABLE AND IMMEDIATE PROSTHESIS
OSSCILIA RETENTIONABUTMENT
IMMEDIATE LOADING CONICAL ABUTMENT
HEXAGONAL
METAL CAP
IMMEDIATE LOADING CONICAL ABUTMENT
CIRCULAR
SOFT RETENTIONSTRENGTH
SCREWDRIVER(MC220PB)
MIDDLE RETENTIONSTRENGTH
STRONG RETENTIONSTRENGTH
+
• Black retainer = Soft retention 2 Kg. For use in laboratory trials.• White retainer = Middle retention 3 Kg. To keep stable for a long period of time.• Red retainer = Strong retention 4 Kg. Only to be used in special cases when a very strong fixation is required.
(*)SCREWDRIVERS(DL120)
(*) Screwdriver liable to change to DC120, MH120 or SUH120RL depending on the case
MINI CAPITEL ABUTMENT
ANGLED MINI CAPITELABUTMENT
ABUTMENTAPPLICATOR
CARRIER PACN
CEMENTABLEABUTMENT
OSSCILIA ENSEMBLE
MINI CAPITEL
IMMEDIATELOADING
SCREWDRIVERS
RETENTION SCREWPROSTHESIS UTSNTR
RETENTION SCREW PROS-THESIS UTSNATR18
MICRODENT GENIUS LABORATORY MANUAL10
CEMENTED PROSTHESISMicrodent Genius Conical (straight) abutment or Microdent Genius Angled abutment Single prosthesis - Multiple prosthesis
HEALING ABUTMENT
CLOSED TRAYSCREW
OPEN TRAYSCREW
TRANSFER
ANALOG
CONICAL ABUTMENTHEX. WITH FLAP
CONICAL ABUTMENTWITHOUT FLAP
CONICAL ABUTMENTCIRCULAR WITH FLAP
ANGLED ABUTMENTHEX. WITH FLAP
ANGLED ABUTMENTHEX. WITHOUT FLAP
SCREW
(*)SCREWDRIVERS(DL120)
Necessary material
(*) Screwdriver liable to change to DC120, MH120 or SUH120RL depending on the case
HEALINGABUTMENT
SCREW (OPENAND CLOSED
TRAY)
TRANSFER SCREW
CONICAL ABUTMENT
ANALOG SCREWDRIVERS
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IMPRESSION TAKING (OPEN TRAY)
Remove the healing abutment with the fixing key and the SUH120RL, DC120HL or DL120HL screwdriver and clean the implant emergence area.
Set the transfer (circular or hexagonal) on the base of the implant ensuring that it is per-fectly settled. Screw it to the implant with a long or short open tray screw using the MH120 screwdriver.
It is recommended to use the individual tray designed at Microdent’s laboratory, but if preferred, a plastic tray with the transfer drilled can be used. Make sure the screw heads stand out 1 mm and ensure they are not trapped in the silicone (sometimes it may be best to cover the open tray screw heads, either long or short, with cotton at the clinician’s discretion).
After testing the fitting, set the material for impressions in the tray (silicone of fluid consistence and putty). Then inject the fluid silicone in the mouth around the transfer and take the impression.
Unscrew the open tray screws (long or short) that emerge from the prepared areas of the tray with the fixing key and the SUH120RL, DC120HL or DL120HL screwdriver, check that all of them are free.
Remove the tray and fix the analog very carefully into the impression (so that they do not move), then cast the impression model with type IV clay (ISO 6873).
Silicone is recommended when simulating soft tissues.
CEMENTED PROSTHESISMicrodent Genius Conical (straight) abutment or Microdent Genius Angled abutment Single prosthesis
CASTING AND PREPARATION OF MODELS
Placing of the false gum
Special silicones are used to model the false implant gum after the crescent shapes of the patient’s gum.
Set the silicone around the analog using a syringe until it reaches a height of 3 mm or 4 mm.
Let the silicone harden for 10 minutes. Then trim it until there is no interference with the neighboring pieces and the correct tissue architecture can be obtained. This affords the practitioner the required space for casting, extraction of the analog, placement during the ceramic loading phase and modeling of its emergence.
Casting
Cast the impression model with type IV clay using the proportions indicated by the manufacturer.
Lightly shake the impression to avoid the appearance of pores while casting it.
Flatten the surface of the clay and leave it as horizontal and thick as possible, so that during the trimming the implant copy does not emerge.
MICRODENT GENIUS LABORATORY MANUAL12
CEMENTED PROSTHESISMicrodent Genius Conical (straight) abutment or Microdent Genius Angled abutment Single prosthesis
ABUTMENT PREPARATIONBefore starting the milling, ensure that the insertion of the posterior crown is with an optimal angle to ensure the contact points are as near as possible to the gum (maximum 4 mm from the jaw bone). Use the parallelometer from the same micro milling machine being used in the process.
The abutment needs to be milling-able without exceeding a length of 4.5 mm measured from the upper part of the abutment. This is necessary in order to avoid any contact with the retention screw.
Once it is parallel, fix the model so it cannot move at all in order to mill it in the desired position. By doing so, the shoulder joint is formed.
DRILL TYPESUse these types of drills or ones with similar features at no more than 15000 r.p.m.
Drill of Tungsten Carbide -EF (Extrafine grain)
Fine S-CuttersFine cross cutters for the finishing touch of the metal alloys, acrylics and plaster.
Advantages• Cross cutters have a large amount of edges for a very accurate finished
• Allows for grainy, short shavings
• Creates smooth cuts almost without any pressure applied
• The smooth surfaces obtained reduce the time needed for additional polishing.
SUB-STRUCTURE CONFECTIONWaxing and casting
Placement of the crown on the abutment for waxing. Wax and model shape the crown depending on the material covering this crown. The practitioner must know the behavior of these materials to avoid any possible physical problems with the patient.
Secure the primary spouts, which are connected to the diffuser, between the secondary spouts. This avoids any contact between the cast and the coating that forms the abut-ment structure of the implant.
Once the wax structure is made, place it into the cast cylinder and proceed to seep the structure in the conventional way.
CERAMIC LOADINGBefore loading the ceramic, prepare the metallic structure by the following procedure:
• Sandblast the exterior of the metallic structure (aluminum oxide from 90 µm and pres-sure of 4 bar). Never the interior of the structure.
• Clean with water and steam brushing. Dry thoroughly.
Apply a specific metal conditioner layer and two opaquer layers of the chosen color. Set the ceramic by stratification.It is very important to let the product slowly cool after each heating phase. Do not open the oven above 720º (for some metals this temperature is even lower, so consult the manufacturer) to let the ceramic crystallize in the optimum way.During the last cementation process, it is recommended the use of glass ionomer cement or cement with similar characteristics.
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CEMENTED PROSTHESISMicrodent Genius Conical (straight) abutment or Microdent Genius Angled abutment Multiple prosthesis
IMPRESSION TAKING (OPEN TRAY)
Remove the healing abutment with the fixing key and the SUH120RL, DC120HL or DL120HL screwdriver and clean the implant emergence area.
Set the transfer (circular or hexagonal) on the base of the implant ensuring that it is perfectly settled. Screw it to the implant with a long or short open tray screw using the MH120 screwdriver.
It is recommended to use the individual tray designed at Microdent’s laboratory, but if preferred, a plastic tray with the transfer drilled can be used. Make sure the screw heads stand out 1 mm and ensure they are not trapped in the silicone (sometimes it may be best to cover the open tray screw heads, either long or short, with cotton at the clinician’s discretion).
After testing the fitting, set the material for impressions in the tray (silicone of fluid consistence and putty). Then inject the fluid silicone in the mouth around the transfer and take the impression.
Unscrew the open tray screws (long or short) that emerge from the prepared areas of the tray with the fixing key and the SUH120RL, DC120HL or DL120HL screwdriver, check that all of them are free.
Remove the tray and fix the analog very carefully into the impression (so that they do not move), then cast the impression model with type IV clay.
CASTING AND PREPARATION OF MODELS
Placing of the false gum
Special silicones are used to model the false implant gum after the crescent shapes of the patient’s gum.
Set the silicone around the analog using a syringe until it reaches a height of 3 mm or 4 mm.
Let the silicone harden for 10 minutes. Then trim it until there is no interference with the neighboring pieces and the correct tissue architecture can be obtained. This affords the practitioner the required space for casting, extraction of the analog, placement during the ceramic loading phase and modeling of its emergence.
Casting
Cast the impression model with type IV clay (ISO 6873) using the proportions indicated by the manufacturer.
Lightly shake the impression to avoid the appearance of pores while casting it.
Flatten the surface of the clay and leave it as horizontal and thick as possible, so that the implant copy does not emerge during the trimming.
MICRODENT GENIUS LABORATORY MANUAL14
CEMENTED PROSTHESISMicrodent Genius Conical (straight) abutment or Microdent Genius Angled abutment Multiple prosthesis
ABUTMENT PREPARATION
Before starting the milling, ensure that the insertion of the posterior crown is with an optimal angle to ensure the contact points are as near as possible to the gum (maximum 4 mm from the jaw bone). Use the parallelometer from the same micro milling machine being used in the process.
Once it is parallel, fix the model so it cannot move at all in order to mill it in the desired position. By doing so, the shoulder joint is formed.
DRILL TYPES
Use these types of drills or ones with similar features at no more than 15000 r.p.m.
Drill of Tungsten Carbide -EF (Extrafine grain)
Fine S-CuttersFine cross cutters for the finishing touch of the metal alloys, acrylics and plaster.
Advantages• Cross cutters have a large amount of edges for a very accurate finished
• Allows for grainy, short shavings
• Creates smooth cuts almost without any pressure applied
• The smooth surfaces obtained reduce the time needed for additional polishing.
SUB-STRUCTURE CONFECTION
Waxing and casting
Placement of the crown on the abutment for waxing. Wax and model shape the crown depending on the material covering this crown. The practitioner must know the behavior of these materials to avoid any possible physical problems with the patient.
Secure the primary spouts, which are connected to the diffuser, between the secondary spouts. This avoids any contact between the cast and the coating that forms the abutment structure of the implant.
Once the wax structure is made, place it into the cast cylinder and proceed to seep the structure in the conventional way.
CERAMIC LOADING
Before loading the ceramic, prepare the metallic structure by the following procedure:
• Sandblast the exterior of the metallic structure (aluminum oxide from 90 µm and pressure of 4 bar.). Never the interior of the structure.
• Clean with water and steam brushing. Dry thoroughly.
Apply a specific metal conditioner layer and two opaquer layers of the chosen color.
Set the ceramic by stratification.
It is very important to let the product slowly cool after each heating phase. Do not open the oven above 720 o (for some metals this temperature is even lower, so consult the manufacturer) to let the ceramic crystallize in the optimum way.
During the last cementation process, it is recommended the use of glass ionomer cement or cement with similar characteristics.
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CEMENT-SCREWED PROSTHESISMicrodent Genius Mini Capitel abutment - Bars for hybrids Multiple cement-screwed prosthesis - Hybrid cement-screwed prosthesis
HEALING ABUTMENT CARRIER PACN
CLOSED TRAY SCREW CEMENTABLE ABUTMENT
OPEN TRAY SCREW
OPEN TRAYTRANSFER
ANGLED MINI CAPITELSCREW
ANGLED MINI CAPITEL ABUTMENT
CLOSED TRAY TRANSFER
MINI CAPITELSCREW
MINI CAPITEL ABUTMENT
ANALOG (*)SCREWDRIVER(DL120)
Necessary material
(*) Screwdriver liable to change to DC120, MH120 or SUH120RL depending on the case
HEALINGABUTMENT
SCREW (OPENAND CLOSED
TRAY)
TRANSFER (OPENAND CLOSED
TRAY)
MINI CAPITELABUTMENT AND
ANGLED MINI CAPITEL ABUTMENT
ANALOG
CARRIER
CEMENTABLEABUTMENT
PROSTHESISSCREW
SCREWDRIVERS
MICRODENT GENIUS LABORATORY MANUAL16
CEMENT-SCREWED PROSTHESISMicrodent Genius Mini Capitel abutment - Bars for hybrids Multiple cement-screwed prosthesis
PLANNING AND PREPARATION OF THE PATIENT FOR SURGERY
Provisional prosthesis
To make a hybrid prosthesis is very important to plan the treatment to ensure a good reaction of the patient to the prosthesis. To do so, the practitioner must make a first pro-visional complete prosthesis to be tested by the patient before placing the implants.
This way, the placement of the implants can be planned and an anatomic-prosthetic compromise can be found. This is very important for the success of the implants and prosthesis as a whole. The need for this procedure is based on functional and aesthetic tests previously done with the complete and provisional prosthesis.
Impression taking and creation of individual tray
Follow the conventional steps to take impressions as if a patient was not going to use implants, i.e., a toothless tray (favored type Schreinemaker). This tray will be used to make study models and subsequently manufacture an individual tray.
Use resin to make an individual tray. Place a wax layer between the resin and the model to leave space for the impression material.
Work impression
Test the tray in the patient’s mouth and, if possible, peripherally seal it to get a good model of the bottom of the mouth vestibule. The impression is made from polysulfide.
Before placement, add adhesive to the tray and wait until it dries. Then vigorously beat the polysulfide and place it in the tray taking the impression.
Casting and manufacture of iron base plates with wax rim
The plaster impressions are casted in plaster to be able to manufacture the iron base plate with wax rims in order to determine the vertical dimension, smile line, middle line and canine teeth line.
The iron is made from resin and with a width of 2-3 mm that adapts perfectly to the edentulous rim.
Once polymerized, place the square wax rim (approx. 8 mm based on the patient’s gum recession, a larger recession requires more height) and send it to the clinic.
Teeth test
When the registers and color dose are done, then proceed to assemble the teeth on the wax to test the prosthesis in the patient’s mouth before muffling and finishing the prosthesis.
The practitioner must check the occlusion, vertical dimension, stability, phonetical tests, aesthetics and eccentric relations during this test.
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CEMENT-SCREWED PROSTHESISMicrodent Genius Mini Capitel abutment - Bars for hybrids Multiple cement-screwed prosthesis
IMPRESSION TAKING (OPEN TRAY)
Remove the healing abutment with the fixing key and clean the implant emergence area.
Set the transfer on the base of the implant ensuring that it is perfectly settled. Screw it to the implant with a long open tray screw.
It is recommended to use the individual tray designed at Microdent’s laboratory, but if preferred, a plastic tray with the transfer drilled can be used. Make sure the screw heads stand out 1 mm and ensure they are not trapped in the silicone (sometimes it may be best to cover the open tray screw heads, either long or short, with cotton at the clinician’s discretion).
After testing the fitting, set the material for impressions in the tray (silicone of fluid consistence and putty). Then inject the fluid silicone in the mouth around the transfer and take the impression.
Unscrew the open tray screws that emerge from the prepared areas of the tray with the fixing key and check that all of them are free.
Remove the tray and fix the analog very carefully into the impression (so that they do not move), then cast the impression model with type IV clay.
Silicone is recommended when simulating soft tissues.
MICRODENT GENIUS LABORATORY MANUAL18
CEMENT-SCREWED PROSTHESISMicrodent Genius Mini Capitel abutment - Bars for hybrids Multiple cement-screwed prosthesis
CASTING AND PREPARATION OF MODELS
Placing of the false gum
Special silicones are used to model the false implant gum after the crescent shapes of the patient’s gum.
Set the silicone around the analog using a syringe until it reaches a height of 3 mm or 4 mm.
Let the silicone harden for 10 minutes. Then trim it until there is no interference with the neighboring pieces and the correct tissue architecture can be obtained. This affords the practitioner the required space for casting, extraction of the implant copy, placement during the ceramic loading phase and modeling of its emergence.
Casting
Cast the impression model with type IV clay (ISO 6873) using the proportions indicated by the manufacturer.
Lightly shake the impression to avoid the appearance of pores while casting it.
Flatten the surface of the clay and leave it as horizontal and thick as possible, so that the implant copy does not emerge during the trimming.
ABUTMENT PREPARATION
Let the silicone harden. Proceed to place the abutments on the model using the fixing key.
In the case of Mini Capitel abutments use cementable abutments.
Waxing and casting
Wax the abutment, keeping in mind that ceramic is loaded onto the abutment.
During the waxing, prepare the space necessary for ceramic loading and compensation (it is important to respect the drilled area of the implant).
Once the wax structure is made, place it into the cast cylinder and proceed to seep he structure in the conventional way.
CERAMIC LOADING
Before loading the ceramic, prepare the metallic structure by the following procedure:
• Sandblast the exterior of the metallic structure (aluminum oxide from 90 µm and pressure of 4 bar.). Never the interior of the structure.
• Clean with water and steam brushing. Dry thoroughly.
Apply a specific metal conditioner layer and two opaquer layers of the chosen color.
Set the ceramic by stratification.
It is very important to let the product slowly cool after each heating phase. Do not open the oven above 720 o (for some metals this temperature is even lower, so consult the manufacturer) to let the ceramic crystallize in the optimum way.
During the last cementation process, it is recommended the use of glass ionomer cement or cement with similar characteristics.
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CEMENT-SCREWED PROSTHESISMicrodent Genius Mini Capitel abutment - Bars for hybrids Hybrid cement-screwed prosthesis
PLANNING AND PREPARATION OF THE PATIENT FOR SURGERY
Provisional prosthesis
To make a hybrid prosthesis is very important to plan the treatment to ensure a good reaction of the patient to the prosthesis. To do so, the practitioner must make a first pro-visional complete prosthesis to be tested by the patient before placing the implants.
This way, the placement of the implants can be planned and an anatomic-prosthetic compromise can be found. This is very important for the success of the implants and prosthesis as a whole. The need for this procedure is based on functional and aesthetic tests previously done with the complete and provisional prosthesis.
Impression taking and creation of individual tray
Follow the conventional steps to take impressions as if a patient was not going to use implants, i.e., a toothless tray (favored type Schreinemaker). This tray will be used to make study models and subsequently manufacture an individual tray.
Use resin to make an individual tray. Place a wax layer between the resin and the model to leave space for the impression material.
Work impression
Test the tray in the patient’s mouth and, if possible, peripherally seal it to get a good model of the bottom of the mouth vestibule. The impression is made from polysulfide.
Before placement, add adhesive to the tray and wait until it dries. Then vigorously beat the polysulfide and place it in the tray taking the impression.
Casting and manufacture of iron base plates with wax rim
The plaster impressions are casted in plaster to be able to manufacture the iron base plate with wax rims in order to determine the vertical dimension, smile line, middle line and canine teeth line.
The iron is made from resin and with a width of 2-3 mm that adapts perfectly to the edentulous rim.
Once polymerized, place the square wax rim (approx. 8 mm based on the patient’s gum recession, a larger recession requires more height) and send it to the clinic.
Teeth test
When the registers and color dose are done, then proceed to assemble the teeth on the wax to test the prosthesis in the patient’s mouth before muffling and finishing the prosthesis.
The practitioner must check the occlusion, vertical dimension, stability, phonetical tests, aesthetics and eccentric relations during this test.
MICRODENT GENIUS LABORATORY MANUAL20
IMPRESSION TAKING (OPEN TRAY)
Remove the healing abutment with the fixing key and clean the implant emergence area.
Set the transfer on the base of the implant ensuring that it is perfectly settled. Screw it to the implant with a long open tray screw.
It is recommended to use the individual tray designed at Microdent’s laboratory, but if preferred, a plastic tray with the transfer drilled can be used. Make sure the screw heads stand out 1 mm and ensure they are not trapped in the silicone (sometimes it may be best to cover the open tray screw heads, either long or short, with cotton at the clinician’s discretion).
After testing the fitting, set the material for impressions in the tray (silicone of fluid consistence and putty). Then inject the fluid silicone in the mouth around the transfer and take the impression.
Unscrew the open tray screws that emerge from the prepared areas of the tray with the fixing key and check that all of them are free.
Remove the tray and fix the analog very carefully into the impression (so that they do not move), then cast the impression model with type IV clay.
Silicone is recommended when simulating soft tissues.
CASTING AND PREPARATION OF MODELS
Placing of the false gum
Special silicones are used to model the false implant gum after the crescent shapes of the patient’s gum.
Set the silicone around the analog using a syringe until reaches a height of 3 mm or 4 mm.
Let the silicone harden for 10 minutes. Then trim it until there is no interference with the neighboring pieces and the correct tissue architecture can be obtained. This affords the practitioner the required space for casting, extraction of the implant copy, placement during the ceramic loading phase and modeling of its emergence.
Casting
Cast the impression model with type IV clay (ISO 6873) using the proportions indicated by the manufacturer.
Lightly shake the impression to avoid the appearance of pores while casting it.
Flatten the surface of the clay and leave it as horizontal and thick as possible, so that the implant copy does not emerge during the trimming.
ABUTMENT PREPARATION
Let the silicone harden. Proceed to place the abutments on the model using the fixing key.
In the case of Mini Capitel abutments use cementable abutments.
Waxing and casting
Wax the abutment, keeping in mind that ceramic is loaded onto the abutment.
During the waxing, prepare the space necessary for ceramic loading and compensation (it is important to respect the drilled area of the implant).
Once the wax structure is made, place it into the cast cylinder and proceed to seep he structure in the conventional way.
CEMENT-SCREWED PROSTHESISMicrodent Genius Mini Capitel abutment - Bars for hybrids Hybrid cement-screwed prosthesis
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CEMENT-SCREWED PROSTHESISMicrodent Genius Mini Capitel abutment - Bars for hybrids Hybrid cement-screwed prosthesis
TEETH TEST
To place the teeth, use the silicone key that has been made with the provisional prosthesis.This way, a copy as similar as possible to the provisional prosthesis is available.Fix the teeth using wax and send the structure to the clinic for teeth testing.
PROSTHESIS FINISHING
If everything is correct according to the teeth tests, then wax, muffle, finish and check the prosthesis.
Adapt the prosthesis to the gums following the aesthetic and functionality requirements of the patient. These requirements are different than that of a fixed prosthesis, where the teeth emerge from the gums and therefore have a larger length.
During the last cementation process, it is recommended the use of glass ionomer cement or cement with similar characteristics.
MICRODENT GENIUS LABORATORY MANUAL22
REMOVABLE PROSTHESISMicrodent Genius Osscilia retention abutment Overdentures, indirect technique
HEALING ABUTMENT OPEN TRAYTRANSFER
OSSCILIA TRANSFER
OPEN TRAY SCREW ANALOG OSSCILIA ANALOG
Necessary material
(*) Screwdriver liable to change to DC120, MH120 or SUH120RL depending on the case
OSSCILIA RETENTIONABUTMENT
METAL CAP SOFT RETENTIONSTRENGTH
SCREWDRIVER(MC220PB)
MIDDLE RETENTIONSTRENGTH
STRONG RETENTIONSTRENGTH
+
• Black retainer = Soft retention 2 Kg. For use in laboratory trials.• White retainer = Middle retention 3 Kg. To keep stable for a long period of time.• Red retainer = Strong retention 4 Kg. Only to be used in special cases when a very strong fixation is required.
OSSCILIA SET
(*)SCREWDRIVER(DL120)
SCREWDRIVERS
ANALOGOPEN TRAY
SCREW
OPEN TRAYTRANSFER
OSSCILIATRANSFER
OSSCILIAANALOG
HEALINGABUTMENT
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PLANNING AND PREPARATION OF THE PATIENT FOR SURGERY
Provisional prosthesis
To make a hybrid prosthesis is very important to plan the treatment to ensure a good reac-tion of the patient to the prosthesis. To do so, the practitioner must make a first provisional complete prosthesis to be tested by the patient before placing the implants.
This way, the placement of the implants can be planned and an anatomic-prosthetic com-promise can be found. This is very important for the success of the implants and prosthesis as a whole. The need for this procedure is based on functional and aesthetic tests previous-ly done with the complete and provisional prosthesis.
Impression taking and creation of individual tray
Follow the conventional steps to take impressions as if a patient was not going to use implants, i.e., a toothless tray (favored type Schreinemaker). This tray will be used to make study models and subsequently manufacture an individual tray.
Use resin to make an individual tray. Place a wax layer between the resin and the model to leave space for the impression material.
Work impression
Test the tray in the patient’s mouth and, if possible, peripherally seal it to get a good model of the bottom of the mouth vestibule.The impression is made from polysulfide.
Before placement, add adhesive to the tray and wait until it dries. Then vigorously beat the polysulfide and place it in the tray taking the impression.
Casting and manufacture of iron base plates with wax rim
The plaster impressions are casted in plaster to be able to manufacture the iron base plate with wax rims in order to determine the vertical dimension, smile line, middle line and canine teeth line.
The iron is made from resin and with a width of 2-3 mm that adapts perfectly to the edentu-lous rim.
Once polymerized, place the square wax rim (approx. 8 mm based on the patient’s gum recession, a larger recession requires more height) and send it to the clinic.
REMOVABLE PROSTHESISMicrodent Genius Osscilia retention abutment Overdentures, indirect technique
MICRODENT GENIUS LABORATORY MANUAL24
REMOVABLE PROSTHESISMicrodent Genius Osscilia retention abutment Overdentures, indirect technique
IMPRESSION TAKING (OPEN TRAY)
Overdentures (indirect technique)
Remove the healing abutment with the fixing key and clean the implant emergence area.
Set the transfer on the base of the implant ensuring that it is perfectly settled. Screw it to the implant with a long open tray screw.
It is recommended to use the individual tray designed at Microdent’s laboratory, but if preferred, a plastic tray with the transfer drilled can be used. Make sure the screw heads stand out 1 mm and ensure they are not trapped in the silicone (sometimes it may be best to cover the open tray screw heads, either long or short, with cotton at the clinician’s discretion).
After testing the fitting, set the material for impressions in the tray (silicone of fluid consis-tence and putty). Then inject the fluid silicone in the mouth around the transfer and take the impression.
Unscrew the open tray screws that emerge from the prepared areas of the tray with the fixing key and check that all of them are free.
Remove the tray and fix the analog very carefully into the impression (so that they do not move), then cast the impression model with type IV clay.
Silicone is recommended when simulating soft tissues.
CASTING AND PREPARATION OF MODELS
Placing of the false gum
Special silicones are used to model the false implant gum after the crescent shapes of the patient’s gum.
Set the silicone around the analog using a syringe until it reaches a height of 3 mm or 4 mm.
Casting
Cast the impression model with type IV clay (ISO 6873) using the proportions indicated by the manufacturer.
Lightly shake the impression to avoid the appearance of pores while casting it.
Flatten the surface of the clay and leave it as horizontal and thick as possible, so that the implant copy does not emerge during the trimming.
Teeth test
When the registers and color dose are done, then proceed to assemble the teeth on the wax to test the prosthesis in the patient’s mouth before muffling and finishing the prosthesis.
The practitioner must check the occlusion, vertical dimension, stability, phonetical tests, aesthetics and eccentric relations during this test.
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COMPLETE PROSTHESIS FINISHING AND COPY
Placement of the Osscilia retention abutment
Once the clay has hardened, place the Osscilia retention abutment.
Also, place the metal cap to create the metallic structure.
Waxing and casting of the structure
Wax the structure keeping in mind that the prosthetic teeth are placed over the metallic structure.
Remove the cap during the waxing process to create an area in the metal to house it. Once the waxing is done, place it into the casting cylinder and proceed to cast the struc-ture following the manufacturer instructions of the metal to cast.
TEETH TEST
To place the teeth, use the silicone key that has been made with the provisional prosthesis.
This way, a copy as similar as possible to the provisional prosthesis is available.
Fix the teeth using wax and send to the clinic for teeth testing.
The teeth test is done with the cap placed in the patient’s mouth for a better accuracy and to check the strength of its housing in the structure.
PROSTHESIS FINISHING
If everything is correct according to the teeth tests, then wax, muffle, finish and check the prosthesis (indirect technique).
Fix the cap in its housing with the resin, sealing the bottom of the cap to prevent any resin from entering.
Adapt the prosthesis to the gums following the aesthetic and functionality requirements of the patient. These requirements are different than that of a fixed prosthesis, where the teeth emerge from the gums and therefore have a larger length.
REMOVABLE PROSTHESISMicrodent Genius Osscilia retention abutment Overdentures, indirect technique
MICRODENT GENIUS LABORATORY MANUAL26
REMOVABLE PROSTHESISMicrodent Genius Mini Capitel abutmentIndirect technique: Cement-screwed bar
Necessary material
(*) Screwdriver liable to change to DC120, MH120 or SUH120RL depending on the case
(*)SCREWDRIVER(DL120)
SCREWDRIVERS
HEALING ABUTMENT
CLOSED TRAY SCREW OPEN TRAY SCREW
OPEN TRAYTRANSFER
ANGLED MINI CAPITEL ABUTMENT
CLOSED TRAY TRANSFER
MINI CAPITEL ABUTMENT
ANALOG
HEALINGABUTMENT
SCREW (OPENAND CLOSED
TRAY)
TRANSFER (OPENAND CLOSED
TRAY)
ANALOG
CARRIER PACN
CEMENTABLE ABUTMENT
ANGLED MINI CAPITELSCREW
MINI CAPITELSCREW
CARRIER
CEMENTABLEABUTMENT
PROSTHESISSCREW
MINI CAPITELABUTMENT AND
ANGLED MINI CAPITEL ABUTMENT
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PLANNING AND PREPARATION OF THE PATIENT FOR SURGERY
Provisional prosthesis
To make a hybrid prosthesis is very important to plan the treatment to ensure a good reac-tion of the patient to the prosthesis. To do so, the practitioner must make a first provisional complete prosthesis to be tested by the patient before placing the implants.
This way, the placement of the implants can be planned and an anatomic-prosthetic com-promise can be found. This is very important for the success of the implants and prosthesis as a whole. The need for this procedure is based on functional and aesthetic tests previous-ly done with the complete and provisional prosthesis.
Impression taking and creation of individual tray
Follow the conventional steps to take impressions as if a patient was not going to use implants, i.e., a toothless tray (favored type Schreinemaker). This tray will be used to make study models and subsequently manufacture an individual tray.
Use resin to make an individual tray. Place a wax layer between the resin and the model to leave space for the impression material.
Work impression
Test the tray in the patient’s mouth and, if possible, peripherally seal it to get a good model of the bottom of the mouth vestibule. The impression is made from polysulfide.
Before placement, add adhesive to the tray and wait until it dries. Then vigorously beat the polysulfide and place it in the tray taking the impression.
Casting and manufacture of iron base plates with wax rim
The plaster impressions are casted in plaster to be able to manufacture the iron base plate with wax rims in order to determine the vertical dimension, smile line, middle line and canine teeth line.
The iron is made from resin and with a width of 2-3 mm that adapts perfectly to the edentu-lous rim.
Once polymerized, place the square wax rim (approx. 8 mm based on the patient’s gum recession, a larger recession requires more height) and send it to the clinic.
Teeth test
When the registers and color dose are done, then proceed to assemble the teeth on the wax to test the prosthesis in the patient’s mouth before muffling and finishing the prosthesis.
The practitioner must check the occlusion, vertical dimension, stability, phonetical tests, aesthetics and eccentric relations during this test.
REMOVABLE PROSTHESISMicrodent Genius Mini Capitel abutmentIndirect technique: Cement-screwed bar
MICRODENT GENIUS LABORATORY MANUAL28
IMPRESSION TAKING (OPEN TRAY)
Remove the healing abutment with the fixing key and clean the implant emergence area.
Set the transfer on the base of the implant ensuring that it is perfectly settled. Screw it to the implant with a long open tray screw.
It is recommended to use the individual tray designed at Microdent’s laboratory, but if preferred, a plastic tray with the transfer drilled can be used. Make sure the screw heads stand out 1 mm and ensure they are not trapped in the silicone (sometimes it may be best to cover the open tray screw heads, either long or short, with cotton at the clinician’s discretion).
After testing the fitting, set the material for impressions in the tray (silicone of fluid consis-tence and putty). Then inject the fluid silicone in the mouth around the transfer and take the impression.
Unscrew the open tray screws that emerge from the prepared areas of the tray with the fixing key and check that all of them are free.
Remove the tray and fix the analog very carefully into the impression (so that they do not move), then cast the impression model with type IV clay.
Silicone is recommended when simulating soft tissues.
CASTING AND PREPARATION OF MODELS
Placing of the false gum
Special silicones are used to model the false implant gum after the crescent shapes of the patient’s gum.
Set the silicone around the analog using a syringe until reaches a height of 3 mm or 4 mm.
Let the silicone harden for 10 minutes. Then trim it until there is no interference with the neighboring pieces and the correct tissue architecture can be obtained. This affords the practitioner the required space for casting, extraction of the implant copy, placement during the ceramic loading phase and modeling of its emergence.
Casting
Cast the impression model with type IV clay (ISO 6873) using the proportions indicated by the manufacturer.
Lightly shake the impression to avoid the appearance of pores while casting it.
Flatten the surface of the clay and leave it as horizontal and thick as possible, so that the implant copy does not emerge during the trimming.
REMOVABLE PROSTHESISMicrodent Genius Mini Capitel abutmentIndirect technique: Cement-screwed bar
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ABUTMENT PREPARATION
Let the silicone harden. Proceed to place the abutments on the model using the fixing key.
In the case of Mini Capitel abutments use cementable abutments.
Waxing and casting
Wax the abutment, keeping in mind that ceramic is loaded onto the abutment.
During the waxing, prepare the space necessary for ceramic loading and compensation (it is important to respect the drilled area of the implant).
Once the wax structure is made, place it into the cast cylinder and proceed to seep he structure in the conventional way.
TEETH TEST
When the registers and color dose are done, then proceed to assemble the teeth on the wax to test the prosthesis in the patient’s mouth before muffling and finishing the prosthesis.
The practitioner must check the occlusion, vertical dimension, stability, phonetical tests, aesthetics and eccentric relations during this test.
The teeth test is done with the attach placed in the patient’s mouth for a better accuracy and to check the strength of its housing in the structure.
PROSTHESIS FINISHING
If everything is correct according to the teeth tests, then wax, muffle, finish and check the prosthesis. Place the corresponding atach for the fastening of the Overdenture in the bar.
Adapt the prosthesis to the gums following the aesthetic and functionality requirements of the patient. These requirements are different than that of a fixed prosthesis, where the teeth emerge from the gums and therefore have a larger length.
During the last cementation process, it is recommended the use of glass ionomer ce-ment or cement with similar characteristics.
REMOVABLE PROSTHESISMicrodent Genius Mini Capitel abutmentIndirect technique: Cement-screwed bar
MICRODENT GENIUS LABORATORY MANUAL30
MRI SAFETY INFORMATION
Implants and abutments have not been evaluated for safety and compatibility in the MR environment. Implants and abutments have not been tested for heating, migration, or image artifact in the MR environment. The safety of implants and abutments in the MR environment is unknown. Scanning a patient who has this device may result in patient injury.
INSTRUCTIONS FOR USE
In accordance and compliance with legal requirements, all implants manufactured by Implant Microdent System have instructions for use. These instructions are available at www.microdentsystem.com
SURGICAL INSTRUMENTS
For a proper use and cleaning of surgical instruments, consult their instructions for use.
GUARANTEE PROGRAM
Implant Microdent System provides guarantees for the products it distributes. The terms and conditions of these guarantees are indicated in the Microdent Implant System “Guarantee Program”, consult their instructions for use: www.microdentsystem.com
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