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Multi-unit
method
For bridge prostheses with screw fixation and
using a multi-unit.
Main
characteristics: Abutments, fixed prosthetics, screw fixation,
prosthesis
on an abutment.
The
impression is obtained using the open spoon method with screw-fixed transfer on
a multi-unit or using intraoral scanning using scan transfers with screw-fixed
transfer on a multi-unit. For this method, straight and angular multi-units are
used - this is a non-removable abutment with a ledge in the crown part, having
a convergence of the walls at an angle of 30 degrees (straight - 610537, etc.,
angular 15 degrees - 630537, etc., angular 25 degrees - 631537, etc.). 610537,
etc., 610548, etc., 611520, etc., 611557, etc., 631537, etc. These devices are
intended only for restoration on two or more osseointegrated implants. The
ledge should be installed below the level of the gingival margin to achieve an
aesthetic result. Multi-units have a height of 0.5 mm, 1.5 mm, 2.5 mm, 3.5 mm,
4.5 mm and are selected in accordance with the thickness of the gum and the
height of the gingival margin above the implant. The doctor removes the
gingival former from the implant and selects a multi-unit for each implant in
accordance with the height of the gingival margin. After this, an impression is
taken:
-the 1st option is by the open spoon method
using a transfer (900037, etc.) ,
-the second option is scanned using a
transfer sphere for scanning (900137, etc.).
Option 1 - The dentist removes the healing cap
(240347, etc.) from the multi-unit. Installs the multi-unit transfers (900037)
for the open tray and fixes them with the transfer screw. It is advisable to
connect the transfers between themselves with quick-hardening plastic. A hole
is made in the impression tray for the transfer screws. The first and second
layers are mixed and introduced simultaneously. After the impression mass has
hardened, the transfer screws are unscrewed. When taking an impression from the
oral cavity, the transfers (900037) remain inside the impression mass. After
taking the impression and removing the transfer from the multi-unit, the
healing cap (240347, etc.) is screwed onto the multi-unit. The impression is
sent to the dental technician. The technician screws
the transfers (900037) into the impression mass using a transfer screw, a
laboratory analogue of the multi-unit (920037) and makes a plaster model with
analogues of an osseointegrated implant + multi-unit.
Dental
laboratory.
The
technician attaches a laboratory analogue of the multi-unit (920037) to the
multi-unit transfers (900037), which are in the impression, using a transfer
screw and makes a plaster model with analogues of the osseointegrated implant +
multi-unit. Then there are several options:
- The technician attaches titanium sleeves
for the multi-unit (680048) to the analogues of the multi-unit (920037). Models
and makes a temporary plastic prosthetic structure with screw fixation. The
finished temporary prosthetic structure with screw fixation is transferred to
the clinic. -Another method of
manufacturing permanent prosthetics on multi-units in the dental laboratory -
the technician attaches plastic sleeves for the multi-unit (680047) to the
multi-unit analogues (920037) for modeling and casting a metal base for a
permanent or temporary prosthetic structure with screw fixation. After
receiving the metal part of the prosthetic structure, the dentist removes the
healing cap (240347, etc.) from the multi-unit, inserts a permanent or temporary
metal structure onto the multi-unit and fixes it to the multi-unit using a
titanium screw M1.6 (701200). Checks that the metal body/structure passively
rests on the multi-unit. Then it is necessary to tighten the screw with a force
of at least 30 N to fix the prosthesis and an X-ray is taken to ensure the
accuracy of the fit of the prosthetic structure on the ledge of the multi-unit.
If the fit is not accurate, it is necessary to cut the body/structure, attach
each fragment separately and connect them using fast-hardening acrylic, then
repeat the try-in and achieve a passive fit of the prosthesis. If the
body/structure is attached well, the dentist selects the color of the veneer
and hands it over to the technician for porcelain veneering. After the body/structure
is removed from the multi-unit, a healing cap (240347, etc.) is screwed onto
the multi-unit.
-Another method of making temporary and
permanent prosthetics on multi-units in a dental laboratory is that the
technician attaches a scan transfer (900137) to the multi-unit analogs (920037)
on the model, then scans, obtains a virtual model and models and makes a
prosthetic structure using a program. Then a titanium base (690764) is cemented
to the manufactured prosthetic structure. The finished prosthetic structure
with screw fixation is transferred to the clinic.
- Another method of making temporary and
permanent prosthetics on multi-units in a dental laboratory - a technician
attaches titanium sleeves for multi-units (680048) to the analogs of
multi-units (920037) on the model. The technician can cut off part of the
sleeve, process it according to the indications, . Then he scans, gets a
virtual model and, using the program, models and makes a prosthetic structure.
Then he cements titanium sleeves for multi-units (680048) to the prosthetic
structure with or without trimming, depending on which part was scanned. The
finished prosthetic structure with screw fixation is transferred to the clinic.
the second
option is scanned using a scanning transfer sphere (900137, etc.).
Option 2 - The dentist removes the healing cap
(240347, etc.) from the multi-unit. Installs the scan transfers of the
multi-unit (900137) on the multi-unit and fixes it with a titanium screw
(701200). Scanning is performed with an intraoral camera. After removing the
scan and removing the transfer from the multi-unit, the healing cap (240347,
etc.) is screwed onto the multi-unit. The file is sent by e-mail to the dental
technician.
Dental
laboratory. Then there are:
1st - The
technician uses the program to print a plastic model using a digital laboratory
analogue of the multi-unit (921037) and receives a model with analogues of the
osseointegrated implant + multi-unit. And it can work as indicated above. The
plastic model with analogs and the plaster model with analogs are identical.
2st - The
technician, using the program, prepares a virtual model with virtual analogs.
And then using the program on the virtual model, builds permanent prosthetics
using a titanium base for multi-units (690764).
Important points are the accuracy of the
fit of permanent prosthetics on multi-units. Intraoral scanners can give
distortions from 30 to 300 microns. And this does not provide an accurate fit
of permanent prosthetics on multi-units. To solve this problem, use the
"Index" - the creation of an additional geometric model. There are 2
types of "Index":
1st use of a
special scanner with sensors for building geometric models. Then this geometric
model is connected with intraoral scanning and this increases the accuracy of
the virtual model with analogs of multi-units.
2nd use of
multi-unit transfers for an open spoon (900037). We install transfers (900037)
on multi-units using a transfer screw. We connect the transfers with
quick-hardening plastic. We unscrew the transfer screw and remove the transfers
from the oral cavity. We connect the transfers (900037) with the analogs of the
multi units (920037) using the screw of the transformer. We immerse the lower
part of the analog of the multi units (920037) in the prepared plaster. After
the plaster hardens, we unscrew the transfer screw and remove the transfers
connected with quick-hardening plastic. We get the "Index" - the
exact geometric location of the implants. The dental technician cements the
finished prosthetics of the titanium bases (690764) on this "Index".
After receiving the finished prosthetic
structure, the healing cap (240347, etc.) is removed from the multi-unit, the
finished prosthesis is again checked for passive fit. The finished prosthetic
structure is fixed to the multi-unit using a titanium screw M1.6 (701200), the
screw is tightened with a force of 30N and an X-ray is taken to ensure the
accuracy of the fit of the prosthetic structure on the ledge of the multi-unit.
After fixing with screws, the holes are closed with silicone or gutta-percha and
composite in accordance with the color of the crown.
