Implant Laboratory Procedures: A Step-by-Step Guide / Edition 1

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Implant Laboratory Procedures: A Step-By-Step Guide provides its readers with a systematic and practical approach to the common dental laboratory procedures associated with implant restorative dentistry. Written with laboratory technicians and restorative dentists in mind, the book is organized by case type, taking common case scenarios and devoting a separate chapter to each one in turn, demonstrating each step of the laboratory procedure required for the implant restoration. Complications associated with the various prosthetic procedures are also included in each chapter and work orders are shown for each and every step. Cases are illustrated with products from various implant companies, but predominantly feature products from Biomet 3i.

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Editorial Reviews

From the Publisher

"This book is certainly appropriate for core reading, and highly recommended for all dental team members who are interested in developing their own teamworking knowledge related to implant provision. As a quick reference and an aide-mémoire when discussing procedural stages it provides a quality reference manual." (Team in Practice, January 2011)

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Product Details

  • ISBN-13: 9780813823010
  • Publisher: Wiley
  • Publication date: 5/3/2010
  • Format: Spiral Bound
  • Edition number: 1
  • Pages: 344
  • Product dimensions: 9.20 (w) x 10.80 (h) x 0.70 (d)

Meet the Author

Carl Drago, DDS, MS, is the Director of Dental Research at Biomet 3i, Palm Beach Gardens, Florida. He is also Adjunct Prosthodontic Faculty at Nova SE University College of Dental Medicine in Ft. Lauderdale.

Thomas Peterson, CDT, MDT, is President of North Shore Dental Laboratories in Lynn, Massachusetts.

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Table of Contents

Foreword xiii

Preface xv

Acknowledgments xvii

Notice for Readers xix

Registered Trademarks xxi

Chapter 1: Introduction to Implant Dentistry 3

Introduction 3

Loading Protocols 3

Traditional, Two-Stage, Unloaded Healing 3

Single-Stage, Unloaded Healing 3

Immediate Occlusal Loading 3

Immediate Nonocclusal Loading 3

Abutments 4

Abutment Selection 6

Surgical Guides 7

Conventional 7

Computer Generated 9

Chapter 2: Mandibular Two-Implant Overdenture 11

Introduction 11

Clinical Patient Presentation 12

Diagnosis 12

Assessment 12

Diagnostic Casts 14

Custom Impression Trays 15

Defi nitive Intraoral Impression 16

Master Cast 16

Record Bases 17

Articulator Mounting 18

Wax Dentures 18

Processing 21

Insertion 24

Chapter 3: Immediate Occlusal Loading—Maxillary Hybrid Prosthesis with Cast Metal Framework (The Columbus Bridge Protocol) 27

Introduction 27

Clinical Patient Presentation 28

Diagnoses 30

Assessment 30

Diagnostics 31

Articulator Mounting 33

Surgical Guide 33

Surgery/Implant Placement 40

Abutment Placement 42

Abutment Impression 44

Jaw Relation Records 46

Master Cast 47

Articulator Mounting 48

Fabrication of Interim Screw-Retained Implant Prosthesis 49

Construction of the Cast Metal Framework 49

Construction of the Hybrid Prosthesis 51

Insertion 54

One-Week Post-Insertion Clinical Visit 56

Chapter 4: Robot Analog Placement and CAD/CAM Abutments 61

Introduction 61

The Encode Complete Restorative System 64

Clinical Patient Presentation 67

Diagnosis 67

Assessment 72

Diagnostic Casts/Surgical Guide 72

Implant Surgery 73

Placement of Healing Abutment 73

Placement of Encode Healing Abutment and Encode Healing Abutment Impression 74

Master Cast 76

Articulator Mounting 77

Encode Complete Work Order 77

Scanning 79

Abutment Design/Milling 80

Robotic Placement of Lab Analog into Cast (Robocast) 81

Fabrication of Porcelain-Fused-to-Metal Crown 85

Clinical Insertion 86

Chapter 5: Maxillary Implant-Retained Primary Bar (CAM StructSURE Precision Milled Copy Milled Bar Framework) with Secondary Casting Maxillary Overdenture; Mandibular CAM StructSURE Precision Milled Bar for Mandibular Hybrid Screw-Retained Prosthesis 93

Introduction 93

Clinical Patient Presentation 93

Diagnoses 95

Assessment 95

Diagnostic Casts/Surgical Guide 96

Implant Surgery 96

Implant-Level Impression—Laboratory Procedures 98

Master Cast 98

Record Bases/Jaw Relation Records 100

Articulator Mounting/Wax Dentures/Verifi cation Index 102

Overview of the Design/Construction of CAD/CAM Frameworks 104

Maxillary Copy Milled Bar 105

Electroformed Bar Sleeves 108

Tertiary Casting 109

Mandibular CAM StructSURE Precision Milled Bar 111

Silicoating 113

Denture Setup on CAD/CAM Frameworks 114

Clinical Try-In Appointment 114

Processing 116

Insertion 121

Contents ix

Chapter 6: Computed Tomography (CT)-Guided Surgery/Immediate Occlusal Loading with a Full-Arch Prosthesis in the Edentulous Mandible 127

Immediate Occlusal Loading 127

Tilted Implants 127

Diagnostic Imaging 127

Computed Tomography (CT) 130

Interactive CT (ICT) 131

Interactive Computer Software 132

Surgical Guides 132

Master Tubes 133

Prosthetic Laboratory Kit—Implant Analog Mounts 133

Surgical Kit Components 134

Fabrication of a Master Cast for an Immediate, Fixed Provisional Prosthesis 135

Abutment Selection for Fixed, Screw-Retained Provisional Prostheses 136

Fabrication of a Screw-Retained Provisional Prosthesis 137

Clinical Patient Presentation 139

Radiographs 141

Diagnosis 141

Assessment 142

Treatment Plan 142

Construction of Wax Dentures 142

Clinical Try-In of the Wax Dentures 145

Fabrication of CT Scanning Appliance 146

Intraoral CT Scan 147

Fabrication of the Master Cast with Implant Analogs 150

Laboratory Abutment Selection and Placement 153

Framework Fabrication (Provisional Prosthesis) 154

Provisional Prosthesis 155

Surgical Implant Placement 157

Clinical Abutment Placement 158

Insertion of Provisional Prosthesis 161

Postoperative Visit 162

Chapter 7: Three-Unit Implant-Retained Porcelain-Fused-to-Metal Fixed Partial Denture with Premachined, Fixed Collar Height Titanium Abutments 165

Introduction 165

Clinical Patient Presentation 168

Diagnosis 168

Assessment 168

Abutment Selection 169

Diagnostics 169

Surgery 169

Abutment Impression 172

Master Cast with Abutment Analogs 173

Waxing Sleeves 174

Defi nitive Prosthesis 175

Insertion 178

Aesthetic Evaluation 178

Chapter 8: Multiple CAD/CAM Abutments with Implant-Retained Porcelain Metal Crowns (The EncodeComplete Protocol) 181

Introduction 181

The EncodeComplete Restorative System 184

Clinical Patient Presentation 187

Diagnosis 191

Assessment 191

Diagnostic Casts/Surgical Guide 192

Implant Surgery 192

Placement of Healing Abutments 193

Placement of Encode Healing Abutments and Encode Healing Abutment Impression 194

Master Cast 196

Articulator Mounting 197

Encode Complete Work Order 198

Scanning 198

Abutment Design/Milling 200

Robotic Placement of Lab Analogs into Cast (Robocast) 201

Fabrication of Porcelain-Fused-to-Metal Crowns 202

Clinical Insertion 206

Chapter 9: Single-Unit Implant-Retained Porcelain Crown with Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) Ceramic Abutment (Encode Zirconia Abutment) 213

Introduction 213

CAD/CAM Protocol—The Encode® Complete Restorative System 219

Clinical Patient Presentation 223

Diagnosis 225

Assessment 225

Diagnostic Casts/Surgical Guide 227

Implant Surgery 228

Placement of Encode Healing Abutment 228

Master Cast 232

Articulator Mounting 232

Encode Complete Work Order 233

Scanning 235

Robotic Placement of Lab Analog into Cast (Robocast) 236

Abutment Design/Milling 240

Fabrication of Porcelain Crown 243

Clinical Insertion 247

Chapter 10: Computed Tomography (CT)-Guided Surgery/Immediate Occlusal Loading with a Full-Arch Prosthesis in Edentulous Maxillae 253

Introduction 253

Tilted Implants 254

Computed Tomography (CT) 255

CBCT 255

Interactive CT 256

Accuracy in CT Treatment Planning 256

Preoperative Planning 257

Clinical Patient Presentation 257

Radiographs 258

Diagnosis 259

Assessment 259

Treatment Plan 259

Construction of Maxillary Wax Denture 259

Clinical Try-in of the Maxillary Wax Denture 262

Fabrication of the Scanning Appliance 262

Intraoral CT Scan 264

Fabrication of the Master Cast with Implant Analogs 265

Laboratory Abutment Selection and Placement 270

Framework Fabrication (Provisional Prosthesis) 273

Provisional Prosthesis 276

Surgical Implant Placement 278

Clinical Abutment Placement 278

Insertion of Provisional Prosthesis 280

Postoperative Visit 283

Chapter 11: Replacement of Denture Teeth and Denture Base for a Preexisting Mandibular Fixed/Detachable Prosthesis 287

Introduction 287

Clinical Patient Presentation 289

Diagnosis 290

Assessment 291

Appointment Sequence 291

Diagnostic Casts 292

Custom Maxillary Impression Tray and Defi nitive Maxillary Impression 293

Maxillary Master Cast 294

Maxillary Record Base and Wax Occlusion Rim 294

Clinical Jaw Relation Records 297

First Articulator Mounting 298

Maxillary Wax Denture 298

Mandibular Master Cast 301

Second Articulator Mounting—Mandibular Master Cast 302

Mandibular Wax Denture 302

Silicoating 304

Processing 306

Insertion 308

Index 313

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