Screw retained Titanium Bridge

k2 Ceramic Studio

k2 Ceramic Studio

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Hi guys, just thought I would share this case as a lot of people are still on the fence over Titanium.

We were asked to construct a simple 3 unit Titanium bridge and if angulation allowed then screw retained.
We made a guide stent for the surgeon to help with placement of the implants.
After integration the job was scanned in a KaVo Scan Pro and designed using multiCAD/Exocad
We milled the bridge in our KaVo 5 axis milling unit out of Grade 2 medical Ti and layered the bridge using GC Initial.

"Dear Peter,
Please find enclosed the radiographs and photos for xxxxxx who you are making a surgical stent for me.
The ridge is very thin and resorbed in the LR5 region, so we are looking at placing 2 x Maxi-Z flat end 4.5 x 10mm implants in the LR6,7 area; as the bone is significantly wider and deeper here.
The plan will be to place a screw retained cantilever bridge after integration of the implants in the LR7,6,5 space to restore the LRQ."

ai1161.photobucket.com_albums_q511_PeterHarling_opg_zpsdcc9e665.jpg ai1161.photobucket.com_albums_q511_PeterHarling_b4implants_zps4e02b5de.jpg ai1161.photobucket.com_albums_q511_PeterHarling_impguide_zps46393168.jpg

Dear Peter,

Please find enclosed the photos for xxxxxx whom I have taken the impressions today for an implant bridge to restore the LR7,6,5.
xxxxxx has a rather large and difficult to control tongue and produces copious amounts of saliva, so I have done the shade photos from the anterior view to try and make my life a bit easier. We are looking at a shade mix of roughly A4, B3, C3.
We have placed two Maxi Z flat end implants in the LR6 and LR7 region and we will have a short cantilever onto the LR5 (as there is a large bony defect here and was not suitable for an implant).

ai1161.photobucket.com_albums_q511_PeterHarling_afterhealing_zps0345099a.jpg

If possible can we have a screw retained bridge on the LRQ with a small occlusal table on the LR5 to limit the forces rotational forces on the implants.
Please let me know if there are any problems.

"We kept the LR5 out of the bite to stop any forces"

ai1161.photobucket.com_albums_q511_PeterHarling_20130116_171005.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_170742.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_170710.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_170649.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_170640.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_165934.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_165814.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_165600.jpg

Many thanks Pete
ai1161.photobucket.com_albums_q511_PeterHarling_opg_zpsdcc9e665.jpg ai1161.photobucket.com_albums_q511_PeterHarling_b4implants_zps4e02b5de.jpg ai1161.photobucket.com_albums_q511_PeterHarling_impguide_zps46393168.jpg ai1161.photobucket.com_albums_q511_PeterHarling_afterhealing_zps0345099a.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_171005.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_170742.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_170710.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_170649.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_170640.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_165934.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_165814.jpg ai1161.photobucket.com_albums_q511_PeterHarling_20130116_165600.jpg
 
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martintay

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Pete were the connections milled or bonded to links ? Either way very nice result.
 
k2 Ceramic Studio

k2 Ceramic Studio

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Hi Martin, No I wish we were milling the connections, in all honesty we can mill bridge connections but it just takes too long as our Cam is not set up for it Yet. So we design the bridge around the prepped abutments and laser weld them together. One day I will buy the implant Cam (one day Lol). The surgeon has an abutment try-in kit and orders what we need for the case, so as soon as it arrived we could crack on. Thanks Pete
 
cheadlemick

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Nice use of the agate slab there Pete! :)
 
k2 Ceramic Studio

k2 Ceramic Studio

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Nice use of the agate slab there Pete! :)
Why thank you Mick Lol. Good to see you had a great time in London, I'm off to GC Belgium in March for some training (no sarcastic comments thanks Mick) What you doing in March? Want to come.......
 
JohnWilson

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Two eng interfaces?
 
k2 Ceramic Studio

k2 Ceramic Studio

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Two eng interfaces?
Thanks John Lol, We are working with the manufacturer of this system to produce a non engaging Ti abutment. All they do is a cast2 gold version. They did mill 4 special ones a couple of months ago for a hader bar case for us, but for now we reduce the sharpness of the hex so it will come on and off then once it is done, after these shots were taken it is mounted in lab putty and the hex is taken down to a tube. As is when the guys who design this stuff dont talk to techs then we have to improvise.
 
JohnWilson

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I had an astra case very much the same situation, I am not sure why companies like NT trading make similar inserts in a non engaging variety.

Your right lots of times the decision makers just don't see the forest through the eye of the tech.

I have been waiting on ELOS to come out with their inserts as well, in the mean time I have just got started with the NT trading versions, I have a big case I need to work on tomorrow.

Nice job, thanks for sharing,
 
cumino

cumino

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Nice job Pete, whats the course in Belgium? GC I presume
pip
 
k2 Ceramic Studio

k2 Ceramic Studio

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Nice job Pete, whats the course in Belgium? GC I presume
pip

Hi Pip, yep its a porcelain course GC is doing, really looking forward to it, been using GC Ti & Zr for 7 years now and just started with the bonded ceramic so I want to learn as much as I can about the porcelain.
 
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