Laboratory Guide2 by thevo

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									Introduction
This guide will show the Laboratory process and considerations for restoring with the Combi System and does not apply to the Ezee Implant System. For predictable and consistant results it is important that this strict list of manufacturing procedures is followed, no stage is more or less important. For technical support and assistance please contact Osteo-Ti on 01481 241117 and ask for our Laboratory Consultant Mr Andrew Jackson.

Disclaimer
This manual is accurate at the time of publication please ensure that you have the latest edition. It is intended for guidance only and you should have received an approved form of implant training prior to using the system. System courses are held at regular intervals and you are advised to contact an Osteo-Ti Consultant regarding the next training session if you are in any doubt about system protocols.

Contents

Laboratory Guide
Impression Protocol Option 1 Option 2 Abutment Preparation Cast-On Abutment Multiple Implants Friction Fit Laboratory Components Instruments Lock-on Abutment Range Abutment Selection 1 3 5 6 7 8 9 10 11 12

Impression Protocol (Clinical Stage)
Option 1: Directly from Implant Head (Fixture Head Impression)

Exposed Fixture Head

Insert QuickTransfer Coping into the Implant

Syringe Impression material through centre of Quick Transfer and side vents

Stock Tray positioned (Use Monopren Transfer or Impregum Hard only)

Quick Transfers are locked in impression

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Laboratory Stage Option 1
1) 2)

Check to see that the Quick Transfers are free of the impression material 3)

Press fit the Analogue firmly on to the Quick Transfer

The impression is cast using the box and bead technique with a high quality stone of 0.08% expansion or less, mixed following the manufacturer’s guidelines

Stone model with intergrated implant Analogues

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Clinical Stage Option 2
From Lock-On Base (Lock-On Base transfer Impression)

Soft tissue healing complete

Insert Quick Transfer Leave Lock-on Base in position and insert Quick Transfer

Syringe Impression material through Centre of Quick Transfer and out through side vents

Stock Tray positioned (Use Monopren Transfer or Impregum Hard only)

Impression with Transfers Locked in position and Lock-On Bases secured to implant head

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Laboratory Stage Option 2
1) 2) 3)

Check to see that Quick Transfers are free of impression material 4)

Press home the Lock-On Bases onto Quick Transfer

Press fit the Analogue onto the Lock-On Bases

The impression is cast using the box and bead technique with a high quality stone of 0.08% expansion or less, mixed following the manufacturer’s guidelines

Stone model with intergrated implant Analogues

Soft Tissue Model Fabrication
Soft tissue reproduction can be achieved using a direct or indirect technique: 1 Direct: Soft tissue material (such as denture soft reline material) is syringed directly around the analogue onto the impression prior to pouring the analogue model. 2 Indirect: Analogue model is cast without any soft tissue and a matrix taken of the implant area (male)

Direct Technique
Soft tissue Reproduction completed The soft tissue region of the analogue model is trimmed away and venting holes cut in to the matrix at the highest and lowest points. The matrix is repositioned on the model and soft tissue material injected into the lowest hole until it emerges from the highest vent hole. The matrix is now removed and soft excess tissue material removed.
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Abutment Selection and Preparation
Standard Prefabricated Abutment
1) 2) 3)

Models are mounted on an articulator ready for diagnostic work, aesthetics and occlusion are checked.

If the head of the implant is 2mm or greater below the soft tissues a castable custom abutment is required, less than 2mm below the soft tissues a standard abutment can be used.

Guide pins are placed into the analogue to determine the definitive abutment required to restore the case.

4)

5)

Definative Pre-angled Abutment chosen.

The abutment is now contoured to create a conventional retaining core with margins 1.5mm below the soft tissues buccal / labial raising to 1mm on the other surfaces.

6)

7)

8)

A metal coping is now constructed in a conventional manner using wax pattern resin ensuring that an intimate contact with the abutment is introduced. The metal coping is cast and trimmed. Fit is checked on the abutment.

The coping is now checked with the matrix to ensure there is enough room in the aesthetic zone to apply the porcelain / gradia etc.

Porcelain / Gradia is applied and finished.

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Abutment Selection and Fabrication
Cast-On abutment
Custom abutments (cast on abutments) are required if the head of the implant is 2mm or greater below the soft tissues, or if the angle of correction is greater than 30 degrees. Machine milled abutments must be kept clean during the manufacturing process. 1) 2)

Insert Cast -on Abutment

Secure the Cast-On Abutment to the Universal Analogue using a Low Profile Screw. Ensure the hex is correctly seated

3)

4)

Trim the plastic sleeve so that the post is within the line of the planned restoration. If additional height is not required the plastic can be removed and the wax (pattern resin) applied directly the the Cast-On Abutment

Wax up the desired customised post. The neck can be waxed up in order to obtain a definate finishing line between the post and crown

5)

6)

Unscrew the Cast-On Abutment and invest. Cast the abutment in a rich yellow gold alloy (e.g. Argenco / Degunom).

6

Following casting the customised post is finished and grit blasted to produce a retentive surface. The neck of the abutment in contact with the soft tissue should be polished to a high finish. The abutment can be screwed into the end of the Lock-On Forming Tool for ease.

Multiple Implants
1) 2) 3)

Models are mounted on an articulator ready for diagnostic work, aesthetics and occlusion are checked.

A matrix is taken of the diagnostic set-up.

If the head of the implant is greater than 2mm below the soft tissues custom abutments are required. Guide pins are placed into the model to determine the abutment required.

4)

5)

6)

The abutments are now contoured to create a conventional retaining core with margins 1.5mm below the soft tissues buccal / labial raising to 1mm on the other surfaces.

The abutments are checked in order to verify a parallel path of insertion.

The framework is checked to ensure a passive fit with no displacement.

7)

8)

For mulitple unit restorations the framework must be returned to the dentist and checked intraorally for accuracy of fit. Pattern resin can be applied to the framework at the laboratory to indicate the bite.

The matrix is used to confirm sufficient intra occlusal space for the application of restorative material and the restoration taken to finish.

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Friction Fit Abutment
This screwless abutment is bonded directly to the gradia or composite material.

It is indicated for the following: 1) 2) Lower teeth, upper premolars and molars. It should not be used in the upper anterior region. Less than 50 to the occlusal plane.

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Laboratory Components
Lock-on Bases
Length mm 3.75 5

Available in four sizes

Lock-on Bases narrow form Code LB3 (short) LB3L (long) LB3 LB3L

Lock-on Bases wide form Length mm 3.75 5 Code LB4 (short) LB4L (long) LB4 LB4L

Any Ezee-Combi Lock-On Base can be used with any Combi implant or Analogue

Quick Transfer
AQT One Transfer Coping fits all implants and Lock-On Bases

One Analogue is used for all implant diameters AUA

Laboratory Analogue

Transmucosal Former
Ø 3mm 4mm Code TMF 1 TMF 2 TMF 1 TMF 2

Low Profile Screw is also required

Low Profile Screws
LPS and HPS HPS only to be used with Transmucosal Formers
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LPS

HPS

Instruments

Lock on Universal Grip
LUG

Selection Wheel
SW

Laboratory Hex Tool
LUHT

Guide Pin Dial System
GPDS

00

50

100

150

200

250

300

Offset angles

50

100 150 200 250 300

Guide Pin Dial System
GPDC = GPDS + LUHT + SW

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Lock-on Abutment Range
Ezee-Combi Abutments
Angle
00 50 100 150 200 250 300 350

Regular Hex

Code
ATP0 ATP5 ATP10 ATP15 ATP20 ATP25 ATP30 ATP35

00

50

100

150

200

250

300

350

LPS

Low Profile Screw fits all screw retained abutments

Ezee-Combi Abutments
Angle
50 100 150 200 250 300 350

Code
AOTP5 AOTP10 AOTP15 AOTP20 AOTP25 AOTP30 AOTP35 50 100

Offset Hex

150

200

250

300

350

LPS

Offset not applicable to 00 Abutment

Low Profile Screw fits all screw retained abutments

Cast-On Abutment
ATP/UCLA

Friction Fit Abutment
Ezee-Combi Friction Retained Abutments
Angle
0
0

Regular Hex

Code
AFP0 AFP5 AFP10 00 50 100

50 100

Ezee-Combi Friction Retained Abutments
Angle
50 100

Code
AOFP5 AOFP10

Offset Hex

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Abutment Selection
Screw Fit Abutment Friction Fit Abutment (Screwless)

Low Profile Screw

Long Low Profile Screw

Cast-on Screw retained

Angled Abutment Screw Retained 0-350

Angled Abutment Screw Retained 0-350

Angled Abutment Friction Retained 0-100

Transmucosal Former

Cast-on Screw retained

Screw Retained Angled Abutment

Thin Wide Transmucosal Transmucosal Former Former

Friction Fit Post

Customisation

Customisation

Cement Retained Restoration

One-Piece Crown and Abutment

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