08-10 Esthetical and functional treatment with implantsupported bar

INDUSTRY/L‘INDUSTRIE
A8
Dental Tribune Canada Edition | May/Mai 2015
Esthetical and functional treatment with implantsupported bar on an incongruous prosthesis carrier
By Carlo Borromeo, Dental Technician, Italy
Introduction
The patient, a 74-year-old female with an
older, total prosthesis, asked us to improve
its esthetics and function. In the initial
exam, we noticed a marked difference between the total upper prosthesis (all but
ruined) and the lower total prosthesis (recently manufactured across four implants).
We also saw immediately that the prosthesis was incorrectly mounted, occupying
too much space and leaving the teeth too
exposed (Fig. 1).
After discussions with the patient, we
AD
agreed to remount both the upper and lower teeth to obtain optimal esthetic results
and restore mastication function. Based on
the speciic demands of the case, we identiied the best retentive-connection system
to connect with the implants and provide
the necessary over-structure, support and
thickness.
Case planning
Impressions were taken to obtain vertical
and centric dimensions. Once the design
met the patient’s need for improved esthetics and function, the dental technicians created vestibular and lingual silicon
masks to guide the building of the struc-
ture and over-structure. Space availability
was evaluated with teeth and implants
position. These analyses enabled identiication of the proper prosthetic treatment to
choose.
A working model was placed under the
parallelometer to identify the proper insertion plan. Different aspects were evaluated: the horizontal line of the incisors, the
occlusion line of the posteriors, the under
spaces by the areas under the frontal ridge
and the implants’ angulation. Once the insertion plan was inalized, castable pivots
were regulated with proper height and
Fig. 1: Patient during irst clinical session.
Photos/Carlo Borromeo
” See PROSTHESIS, page A10
Fig. 2: Positioning of the ‘OT Bar.’
Fig. 3: Checking of the dimensions using the
vestibular plaque.
Fig. 4: Checkng precision of the bar on the
model before inishing.
Fig. 5: Check of the spaces for pipe cleaner.
Fig. 6: Spruing of superstructure on model.
Fig. 7: Re-application of teeth using plaques.
Fig. 8: Polishing of the structure.
Fig. 9: Insertion of the pink caps in the
structure.
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INDUSTRY/L‘INDUSTRIE
A10
Dental Tribune Canada Edition | May/Mai 2015
NSK Dental introduces ‘dentistry’s most powerful
air-driven handpiece’ NSK Dental présente la
turbine la plus puissante en dentisterie
JDIQ
BOOTH NO.
1909
New cartridge design improves durability; smaller head sizes enhance operational visibility
Dental equipment manufacturer NSK
Dental LLC has launched what it describes
as the dental industry’s most powerful
air-driven handpiece, the 26-watt, standard head Ti-Max® Z900L series. The
company is also launching the 23-watt,
miniature-head Ti-Max Z800L series.
“This is our biggest new product launch
ever, as the Ti-Max Z900L is the irst airdriven handpiece in the history of the
dental industry that delivers 26 watts of
power,” said Rob Gochoel, sales and marketing director for NSK Dental.
“This unprecedented torque reduces
treatment time and provides remarkably smooth handling because of the
high power output and a unique new
turbine design,” Gochoel said. “Equally
impressive, the unprecedented 23 watts
of power delivered by our new Ti-Max
Z800L miniature head series exceeds the
power delivered by most standard-head
handpieces that are on the market today.”
According to the company, both the
Ti-Max Z900L and Z800L series feature a
new cartridge design to dramatically improve durability — and have smaller head
sizes to enhance operational visibility.
They also feature cartridges that
can be replaced chairside
to save time and
maintain practice productivity. Both
series feature ergonomic, solid titanium
bodies and NSK’s new DURAGRIP® coating, which makes the handpieces easy to
hold, even when wet. To further enhance
ergonomics, the handpiece body features
a notch for resting the thumb and index
inger for maximum leverage. A Quattro
(four-port) water spray and 2.5-year warranty — NSK’s longest ever — complete
the offering. Multiple backend types are available to it most
competitive couplers,
including
KaVo and W&H.
As with NSK’s other air-driven and
electric handpieces, 100 percent of the
Ti-Max Z900L and Z800L series’ components are engineered, manufactured
and assembled in house at NSK’s factory
in Kanuma, Japan, to ensure quality and
reliability.
NSK Dental is the North American subsidiary of Kanuma, Japan-based Nakanishi Inc. and is located in Hoffman Estates, Ill. Additional information about
the Ti-Max Z900L and Z800L series, as
well as other NSK Dental products, can be
found at www.nskdental.com.
(Source: NSK)
• Both the Ti-Max Z900L (pictured) and Z800L series feature ergonomic,
solid titanium bodies and NSK’s new DURAGRIP coating, which makes the
handpieces easy to hold, even when wet. The handpiece body also features a notch for
resting the thumb and index inger for maximum leverage. Photo/Provided by NSK • Les deux séries
mettent en valeur l’ergonomie, une construction de titane solide et le nouveau recouvrement DURAGRIP® de NSK,
qui rend les pièces à mains faciles à tenir même lorsqu’elles sont trempes. Des encoches comme points d’appui pour le pouce et
l’index sur le corps de la pièce à main rehaussent l’ergonomie encore plus, ainsi que l’effet de levier de l’instrument. Photo/Gracieuseté de NSK
Le nouveau design du roulement améliore la durabilité; la petite tête augmente la visibilité
Le fabricant d’équipement Dentaire NSK
Dental LLC a présenté ce qu’il décrit comme la turbine pneumatique la plus puissante de l’industrie dentaire, la série TiMax® Z900L à tête standard de 26 watts.
La compagnie présente aussi la série TiMax Z800L à tête miniature de 23 watts.
Rob Gochoel, directeur des ventes et du
marketing pour NSK Dental, afirme que
ceci est notre plus gros lancement à ce
jour, car la Ti-Max Z900L est la première
turbine pneumatique de l’industrie dentaire à donner 26 watts de puissance.
D’après Gochoel, cette force de couple
sans précédent réduit le temps de traitement. Le nouveau design des roulements
à billes et sa grande puissance fournissent
un fonctionnement en douceur remarquable. Tout aussi impressionnante, la
force de 23 watts sans précédent, fournie
par notre nouvelle Ti-Max Z800L à tête
miniature, dépasse la force de couple de la
plupart des pièces à mains disponibles sur
le marché d’aujourd’hui.
D’après l’entreprise, à la fois les séries Ti-Max Z900L et Z800L, mettent en
valeur un nouveau design de cartouches
qui améliorent énormément la durabilité
et possèdent une tête plus petite qui rehausse la visibilité opérationnelle. De plus,
les cartouches peuvent être remplacées à
la chaise, ce qui sauve du temps et assure
la productivité de la clinique.
Les deux séries mettent en valeur
l’ergonomie, une construction de titane
solide et le nouveau recouvrement DURAGRIP® de NSK, qui rend les pièces à mains
faciles à tenir même lorsqu’elles sont trempes. Des encoches comme points d’appui
pour le pouce et l’index sur le corps de
la pièce à main, rehaussent l’ergonomie
encore plus, ainsi que l’effet de levier de
l’instrument. Le jet d’eau Quattro (4 oriices), avec une garantie de 2.5 ans- la plus
longue jamais offerte par NSK- complète
l’offre. Plusieurs branchements sont disponibles pour s’adapter à la majorité des
compétiteurs, incluant Kavo et W&H.
“ PROSTHESIS, page A8
The inished artifact was delivered to the
clinic, where the necessary tests and radiographs were obtained. Once veriied that all
the parameters were correct and that the
structure was passive, the bar was milled
and polished at the lab. On the model,
spaces were veriied for the application of
pipe cleaners. This same test would be conducted later in the patient’s mouth (Fig. 5).
Using the silicon plaques, we built the
superstructure directly on the bar, starting
by positioning the containers of the caps.
Castable boxes were applied onto those, always using the silicon plaques. After avoiding the undercuts with wax, we isolated
the bar and the model and then built the
superstructure using resin. We removed it
from the superstructure and pasted the retentions. Everything was set up to proceed
with the spruing directly on the model
(Fig. 6). After the coating was melted off,
precision and friction was veriied using a
revealing-paint on the bar. The teeth were
applied with the aid of silicon masks (Fig.
7). The containers of the clips continued
to be replaced with pink caps. Everything
was delivered to the clinic for the inal test.
With the prosthesis back at the laboratory,
wax ittings were converted to resin ittings
and the superstructure was inished and
polished (Fig. 8). After applying it again on
the superstructure, undercuts were closed
with some wax, and the resin was applied
to the prosthesis (Fig. 9). All the components of the prosthesis were polished and
delivered to the clinic for the inal test (Figs.
10 and 11).
screwed, guided by the silicon mask. Next
came creation of the castable bar by setting
it — area-after-area — using resin to ix it at
the external areas (Fig. 2).
Once all the parts of the structure were
connected, we regulated the areas over the
implants using a two-degree bur. The technician then checked everything using the
silicon masks (Fig. 3). After we conirmed
that the bur met all our expectations, we
started the sprue procedure. We proceeded
with the fusion through a special pressfusion procedure. Once it was veriied that
the bar respected all the desired characteristics, we continued with the spruing,
directly on the model to avoid distortions
during the cooling of the wax. We then
proceeded with the melting, using the “diecasting” technique. We conducted a irst
test immediately after cleaning the coating
(Fig. 4).
.
Conclusions
With adequate components, retention
systems on implants and readily available technical and clinical knowledge
and resources on complete dentures, you
can obtain excellent results in short work
times, using both traditional systems and
CAD/CAM.
Pour ce qui est des autres turbines pneumatiques et des moteurs électriques NSK,
tels que dans les séries Ti-Max Z900L et
Z800L, 100% des composantes sont conçues, fabriquées et assemblées dans notre
usine de Kanuma au Japon pour en assurer la qualité et la iabilité.
Située à Hoffman Estates, Ill., NSK Dental est la iliale pour l’Amérique du Nord
de Nakanishi Inc de Kanuma au Japon.
Pour plus d’informations sur les séries TiMax Z900L et Z800L, ainsi que sur les autres produits de NSK Dental, visitez : www.
nskdental.com
(Source: NSK)
Fig. 10: Finished prosthesis and bar.
Fig. 11: Final results after screwing bar into
the mouth and applying prostheses.
CARLO BORROMEO founded Dental
Laboratory Borromeo in Italy in
1988,
specializing
construction
implants
in
the
of
prosthesis
for
using
CAD/CAM.
He
collaborates with Nobel Biocare
Procera, Dental Wings, Rhein’83 and
other companies to improve his expertise with their
materials. He is highly published and presents many
dental lab courses and conferences.