Convertible Abutment. Introduction. Prosthetic Flow Diagram for GS Convertible Abutment. Configuration of GoldCast Cylinder

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1 Prosthetic Flow Diagram for GS Cement & Screw & Combination Retained Restoration for Mini, Regular, Wide - Abutment Level Impression Taking Introduction Cylinder Screw(WCC) Three types of cylinder (combination, combination angled, goldcast) enable various types of prosthesis treatment: cement, screw and combination. Combination Cylinder Combination Angled Cylinder GoldCast Cylinder This abutment level impression includes transfer type and pick-up type impression methods. GoldCast Cylinder makes laboratory work easy and convenient because it uses direct casting in gold alloy for making prosthesis. Configuration of GoldCast Cylinder Transfer Lab Analog Transfer Impression Coping & Cap Pick-Up Impression Coping Combination 17 angled cylinder makes easy for path compensation of fixture. Design of anti-rotation between Abutment and cylinder, and easy removal, enables path compensation up to maximum 60 angle. Torque Wrench Protect Cap Special-purpose carrier eases the connection of abutment Left : 17 Δ Combination Angled Cylinder Right : Path Compensation of Driver Healing Abutment Cover Screw 1.2 Hex Driver GS II Fixture

2 Step1 Separating the Cover Screw and Healing Abutment Step2 Connecting the Components & Tools s & Driver Torque Wrench Short Long 1.2 Hex Hand Driver 1.2 Hex Torque Driver C mm Abutment connected to the carrier Short Long Mini Regula / Wide Driver Cover Screw Dimension marks for identification C mm Healing Abutment C D Healing Abutment Specification D( ) C(mm) Mini 4 1/2/3/4 Regular 5 1/2/3/4 Wide 6 1/2/3/4 C D Specification D( ) C(mm) Mini 4 1/2/3/4 Regular 4.8 1/2/3/4/5 Wide 6 1/2/3/4 Convertible abutment can compatibly use the OSSTEM implant tools. Use an o- ring driver for mini type, and Octa-driver for regular and wide types. Separate the cover screw or healing abutment using a 1.2 hex hand driver. To prevent the patient from swallowing the hand driver, tie dental floss to the spinner on the handle of the driver. Consider the gingival condition inside the oral cavity and the occlusion gap, select a convertible abutment with adequate collar height and diameter and prepare impression components. Place a convertible abutment precisely on the grated fixture inside the oral cavity, then initially tighten by seizing and turning the top carrier. After the connection of the abutment, adding force by flipping the carrier aside can be easily separated. After the separation of the carrier, connect a specialpurpose Octa driver to a torque wrench and lastly tighten to 30N cm. Healing Abutment connected to Left : Separating the cover screw using a driver Right : Hand driver with dental floss tied to the handle Connecting the convertible abutment Tightening to 30N cm 88 for GS Implant System 89

3 Co rrect Method to Separate the Carrier Step3 Connecting the Pick-up Impression Coping Pick-Up Impression System mm Convenient way Inconvenient way Align the impression coping on the abutment and lock the guide pin, and lastly tighten by using a 1.2 hex hand driver. After the connection, check the connection of the coping and the fixture via X-ray. Connect each coping with adjacent coping using pattern resin so as to minimize impression coping errors that can occur while taking an impression and making a model. Connecting the impression coping Securing each coping Securing using pattern resin Secured coping 90 for GS Implant System 91

4 Step4 Taking the Impression Prepare an open tray that has a hole to allow the guide pin to be exposed outside, and inject rubber impression material without gap, then take the impression. Once the impression material is hardened, remove the guide pin using a 1.2 hex hand driver and separate the impression body. Step5 Convertible Protect Cap Connecting the Protective Cap Making the individual tray Injecting impression material Taking the impression Removing the guide pin While constructing the upper prosthesis, fasten the protective cap to abutment in the oral cavity to eliminate the foreign body sensation felt by the patient and protect the abutment. Created impression body Connected protective cap 92 for GS Implant System 93

5 Dental Lab Working Step6 Making the Working Model Step7 Convertible Combination Cylinder Convertible Lab Analog Convertible Combination Cylinder Combination Cylinder Combination Angled Cylinder Precisely connect the lab analog into the impression coping inside the impression body and lock it using the guide pin and a 1.2 hex hand driver. Check if the coping is properly placed in the analog, then form artificial gum around the analog. Next, pour stone to create a working model ( Note : after checking the coping inside the impression body, make sure to grab the analog with hand and then tighten using a driver). Connecting the lab analog Completed analog Forming artificial gum Select a convertible combination cylinder and a combination angled cylinder depending upon the grating angle of the fixture. Align them upward on the top analog on the model, then tighten using a 1.2 hex hand driver. Create an ideal abutment post using a grinding tool and milling machine. Pouring stone Completed working model Checking the path of the fixture Connecting the cylinder on the model Cylinder placed properly Milling 94 for GS Implant System 95

6 Dental Lab Working Step8 Waxing-up, Casting & Performing Porcelain build-up Form a screw hole and create a PFM prosthesis in the conventional manner. Step9 Making the Transfer Jig Remove artificial gum on the model and precisely connect the convertible cylinder using a 1.2 hex hand driver, then construct pattern resin to make a transfer jig. It is necessary to create the transfer jig to replace the combination cylinder on the model into the same position inside the oral cavity. Waxing-up Spruing Transfer jig made pattern resin Separated transfer jig and cylinder Casting body Building-up Firing Completed prosthesis 96 for GS Implant System 97

7 CASE : 5 PFM Regular Platform Screw Type Restoration Step10 Mounting the Prosthesis Step1 Separating the Cover Screw and the Healing Abutment Separate the protective cap connected to the abutment, place a customized cylinder with milling on the abutment using the transfer jig. Temporarily tighten the cylinder using a 1.2 hex hand driver and a cylinder screw and try the fit of the completed prosthesis. Next, check the passive fit of the prosthesis margin, the occlusion and aesthetics. Once finished with prosthesis check, tighten the prosthesis to 30 Ncm using a 1.2 torque driver and a torque wrench. Block out the screw hole and finally cement, then re-make the occlusion surface with resin. Components & Tools Torque Wrench Short Long 1.2 Hex Hand Driver 1.2 Hex Torque Driver Dimension marks for identification D Connecting the cylinder using the transfer jig Trying the fit of the prosthesis Blocking out the screw hole Cover Screw C mm Healing Abutment C Healing Abutment Specification D( ) C(mm) Mini 4 1/2/3/4 Regular 5 1/2/3/4 Wide 6 1/2/3/4 Cementation Forming the occlusion surface Completed prosthesis Separate the cover screw or healing abutment using a 1.2 hex hand driver. To prevent the patient from swallowing the hand driver, tie dental floss to the spinner on the handle of the driver. In consideration of the gingival condition inside patient s oral cavity and the occlusion, select a convertible abutment with an adequate collar height and diameter, then prepare impression components. Patient Follow-Up Upon the completion of prosthetic treatment, provide the patient instructions in oral hygiene and make an appointment for next checkup. Healing abutment connected to 5 Left : Separating the healing abutment using a driver Right : 1.2 hex hand driver with dental floss tied to the handle 98 for GS Implant System 99

8 CASE : 5 PFM Regular Platform Screw Type Restoration Step2 Connecting the Step3 Connecting the Transfer Impression Coping s & Driver Convertible Transfer Impression Coping C mm Abutment connected to the carrier Short Long Mini Regular / Wide Driver cap Convertible transfer coping connected to the plastic cap C D Specification Convertible abutment can compatibly uses the OSSTEM implant tools. Use an o-ring driver for mini type, and Octadriver for regular and wide types. D( ) C(mm) Mini 4 1/2/3/4 Regular 4.8 1/2/3/4/5 Wide 6 1/2/3/4 Place a convertible abutment precisely on the grated fixture inside the oral cavity, then initially tighten by seizing and turning the top carrier. After the connection of the abutment, adding force by flipping the carrier aside can help ease of separation. After the removal of the carrier, connect a specialpurpose Octa driver to a torque wrench and tighten to 30Ncm. Align the impression coping on the abutment, and lock the guide pin using a 1.2 hex hand driver. Connect the special-purpose plastic impression cap until a click sound is produced, and check the connection of the coping and the abutment via X-ray. Connecting the abutment using the carrier Separating the carrier Guide torque (30 Ncm) Connecting the transfer impression coping 100 for GS Implant System 101

9 CASE : 5 PFM Regular Platform Screw Type Restoration Step4 Taking the Impression Inject light body of impression material without gap around the impression cap and inject heavy body of impression material on the closed tray, then take the impression. After the impression material is hardened, remove the impression body from the oral cavity. Separate the transfer impression coping connected to the oral cavity, and connect the lab analog. Check the marked surface on the impression body, and connect the connected lab analog and the transfer impression coping to the internal plastic cap until a click sound is produced. Step5 Convertible Protect Cap Connecting the Protective Cap Injecting impression material Completed impression body Connecting the analog and the coping Placing the connected coping and analog precisely onto the impression body While constructing the prosthesis, fasten the protective cap using a 1.2 hex hand driver to eliminate the foreign body sensation felt by the patient and protect the abutment. Connected protective cap inside the oral cavity 102 for GS Implant System 103

10 Dental Lab Working CASE : 5 PFM Regular Platform Screw Type Restoration Step6 Making the Working Model Step7 Waxing-up, Casting & Performing Porcelain Build-up Convertible Lab Analog Convertible GoldCast Cylinder Place a GoldCast cylinder upward on the lab analog positioned on the model, and connect it with a screw using a 1.2 hex hand driver. After adjusting the plastic sleeve to an appropriate height, wax-up it for the lower structure of the prosthesis ( Note : Precious metal alloy should be used for casting metal. Non-precious metal alloy casting causes deformation of gold cylinder by heat.) Form a screw hole and wax-up, then create a PFG prosthesis in the conventional manner. Form artificial gum around the transfer impression coping and the lab analog connected to the impression body, then create a working model by pouring stone. Connecting the GoldCast cylinder Adjusting the height and diameter Wax-up Injecting stone Completed working model Spruing Casting body Completed prosthesis 104 for GS Implant System 105

11 CASE : 5 PFM Regular Platform Screw Type Restoration Mounting the Prosthesis Step8Separate the protective cap connected on the abutment inside the oral cavity, and Ca utions for the Use of Gold Cylinder try the fit of the final prosthesis on the abutment. Check the passive fit of the margin, the occlusion and aesthetics, then initially tighten using a 1.2 hex hand driver. Lastly tighten the prosthesis to 30 Ncm using a 1.2 torque driver and torque wrench. Block out the hole on the occlusion surface, then re -make the occlusion surface with resin. Mounting the final prosthesis Forming the occlusion surface Inside convertible gold cylinder with non-precious alloy casting Inside convertible gold cylinder with gold alloy casting Patient Follow-Up Upon the completion of prosthetic treatment, provide the patient instructions in oral hygiene and make an appointment for next checkup. If the final upper prosthesis is restored with ceramic, be careful to use gold abutment or gold cylinder for the use of casting metal. Non-precious alloy casting causes deformation of embedded internal/external gold cylinder due to high temperature of non-precious ally casting, as shown in the above figure. Melting point (C ) Gold Cylinder/GoldCast Abutment Ceramic Gold Alloy / Gold Alloy Ni-Cr Alloy 1400~1450 C 950~1150 C 1300~1400 C If creating a prosthesis through direct casting with gold cylinder, the melting point of casting metal should be at least 200+ C lower than that of gold cylinder, thus preventing deformation of the gold cylinder by a high casting temperature. 106 for GS Implant System 107

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