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BAR RETAINED OVERDENTURE

Components Required:
Cone-Top Abutment (PA0221 or PA0222)
Note: Accessories are not included with the abutment.

The PerioSeal Cone Top Abutment provides the components of a Cast Gold Alloy or Welded Titanium Bar for denture retention. There are two procedures for restoration using the cone top abutment. It is the choice of the clinician as to which method best accommodates a particular case. Both methods are outlined for consideration.

In the first method, an impression of the implants is recorded and a soft tissue model is fabricated with implant analogs. In the second method, the cone top abutments are placed at the second stage surgery and the model is fabricated with cone top implant analogs.

Restoration using Implant Analogs:
The implants are uncovered after appropriate healing of the tissues and a tissue contour abutment is placed to flare the soft tissue. A soft tissue working model is fabricated using implant analogs.

  1. An impression is recorded of the implants. (See impression and transfer technique)
  2. A model is fabricated and sent to the lab with the appropriate cone top abutments.
  3. A cast bar is fabricated by placing a cone top abutment into each implant analog and attaching a gold alloy coping with a plastic sleeve (PA3012) using a cone top screw (PH0018). The bar is formed by waxing between the copings. The bar is then cast using normal laboratory procedures.
  4. The lab then delivers the bar and the cone top abutments.
  5. The healing abutments are removed from the patient by loosening the screw with the .050 hex driver 1 or 2 turns and pulling the abutments out. Note: It is important to verify that the expansion nuts are on the healing abutments and not remaining in the implant in the patient.
  6. The cone top abutment is placed into the implant and the cone top abutment hex is aligned with the hex in the implant. A cone top hex driver is placed over the abutment and loosened 1 or 2 turns while gently pressing the abutment into the implant. When the abutment advances into the implant, the implant is tightened to 35 ncm.
  7. The bar is evaluated for passive fit in the patient. After verification of a passive fit, the bar is attached using the cone top screw (PI0018) tightened to 30ncm. Note: It is recommended that all screws be inserted and tightened hand tight before final tightening.

Restoration using Cone Top Abutments at Second Stage Surgery:
The appropriate size cone top abutment may be placed in the implant at the time of second stage surgery. An impression is taken of the abutment using a cone top impression post (PI0025) and a working model is fabricated using the cone top implant analog (PI0232) to make a working model.

  1. The healing cap is removed from the implant by loosening the screw 1 or 2 turns and pulling the cap out. It is important to verify the retention nut is on the healing cap. The appropriate size cone top abutment is placed into the implant by locating the hex in the implant and aligning it with the hex on the abutment. The abutment is loosened 1 or 2 turns while applying gentleforce to push it into the implant. The abutment is then tightened to 35 ncm.
  2. A cone top impression post (PI0225) is installed on the abutments with a retaining screw (PI0018). The impression is then recorded.
  3. The impression posts are removed from the abutments in the patient and attached to cone top implant analogs. The impression posts are then reinserted into the impression for fabrication of a working model.
  4. A cast bar is fabricated on the working model. A gold alloy coping with a plastic sleeve (PA0018)is fastened to each cone top implant analog using a cone top screw (PH0018). The bar is formed by waxing between the copings. The bar is then cast using normal laboratory procedures.
  5. The bar is evaluated for passive fit in the patient. After verification of a passive fit, the bar is attached using the cone top screw(PI0018) tightened to 30ncm.

Note: it is recommended that all screws be inserted and tightened hand tight before final tightening.Welded Titanium Bar

Components required for the Titanium Bar Coping
A welded titanium bar may be fabricated using a titanium bar coping. This service is offered by some dental labs. The procedures outlined above are the same for a welded titanium bar with the substitution of the titanium coping for the gold coping.