ifu.anthogyr.com · 2 Thank you for your trust and for choosing the Axiom® Multi Level® implant...

Prosthetics User Guide

A BL - TL

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Thank you for your trust and for choosing the Axiom® Multi Level® implant solution.

This document contains necessary information for using the Axiom® Multi

Level® device with restoration protocols specific to the Axiom® Bone Level and

Axiom® Tissue Level systems, as well as the entire component list.

Success for you means success for us. Our marketing network and team of

experts is always available to you for any further information that you may

need.

Anthogyr

> Scope The Axiom® Multi Level® system is exclusively intended to replace missing teeth. It enables one or more artificial roots to be positioned, onto which dental prostheses are fixed and/ or stabilised. The system allows single-unit, multiple-unit or complete restoration to be performed.

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A Mult i Level ® PROSTHETICS USER GUIDE

INSTRUCTIONS AVAILABLE ONLINE

ifu.anthogyr.com You can now find instructions for use (instructions and manuals) for Anthogyr implants and prosthetics parts in PDF

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INFORMATION UPDATES:

Instructions for use are updated regularly and indicated with the “New” pictogram. Updated instructions can impact pa-tient safety. For this reason, we suggest you to avoid local back-ups and advise you to always check the Anthogyr portal. To access archived instructions, click on “View old document versions.” You can also receive paper copies of instructions at no additional cost. To receive paper copies, fill out the form available under the “Contact” tab or include a request with your next order. Make sure to include your desired language. The document will be delivered to you within 7 calendar days. We are available if you have any comments or suggestions, via the “Contact” tab.

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> Warnings and recommendations The instructions contained in this document describe the different phases of the surgical procedure and prosthetic res-toration to be followed for the Axiom® Multi Level® implant system. A few general features specific to inserting implanta-ble devices are recalled for information. This is not in any way an exhaustive document about implant and prosthetic

practices to which the reader has any right of complaint

TRAINING: Axiom® Multi Level® components should only be used by practitioners who have been trained in implant practice and/or prosthetic techniques, and who are equipped for this type of procedure. Correct knowledge of surgical techniques and

prosthetics is required to use this system. Specific training is offered and delivered at the Anthogyr company.

The surgical and prosthetic technique for the Axiom® Multi Level® system is performed exclusively in conjunction with the original components and instruments in accordance with the manufacturer’s recommendations. Anthogyr can take no responsibility in case of placement non-compliant with this manual and in case of use of implants or prosthetic parts

or instruments foreign to the system.

Clinical evaluation of the patient and the choice of treatment solution are the sole responsibility of the practitioner. The implant diameter and length must be determined beforehand by the dental practitioner, depending on the clinical situa-tion. Patients should also be informed of potential risks associated with implanting this type of device: oedema, bruising, haemorrhage, periodontal complications, transient or permanent nerve damage, local or systemic infections or inflam-mation, bone fractures, loosening or fracture of the implant, dehiscence, aesthetic problems, aspirating or swallowing

the device, iatrogenic trauma etc.

EQUIPMENT: The practitioner using the system is responsible for the follow-up and maintenance procedures required to identify and treat any complications as early as possible and for ensuring the correct functioning and safety of the device. The refer-ences and the batch numbers of all components implanted, temporarily and/or definitively, must be recorded in the

medical file of the patient.

Follow-up and maintenance are part of the knowledge of a practitioner trained in placing dental implants.

The practitioner is also responsible for defining the different settings for his/her equipment (instrument rotation speed, irrigation flow rate, etc), according to each clinical case, and for confirming that these are in good condition before each

procedure.

Reusable instruments must be cleaned, decontaminated and sterilised before each surgery (even when first used) in accordance with current protocols in hospitals and clinics. The organisation of the operating room, preparation of oper-ating staff and of the patient (premedication, anaesthesia, etc…) should follow current procedures and are the responsi-

bility of the practitioner.

Anthogyr can under no circumstances be held responsible for any harm arising from defective handling or use. In order to avoid swallowing or inhaling small components, it is recommended that these are rendered secure by fixing them to the outside of the mouth with a suture thread. Whenever an instrument is changed, confirm that the contra-angle or key are correctly fixed by applying slight traction and ensure that each part is correctly fixed onto the transfer system out-

side the oral cavity.

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Explanations, symbols and diagrams on the labels

CONSERVATION: In producing our products, we have paid particular care and guarantee that a manufacturing control has been performed on all products made available for sale. In order to guarantee their integrity, it is recommended that they be stored in

their original packaging at an ambient temperature of between 15 and 30°C, away from moisture and direct sunlight.

Protect packages from dust and do not store in the same premises as solvents and/or paints containing solvents or

chemical substances. The device must be used before the expiration date indicated on the traceability label.

If the package (blister-closure / bag) is damaged or a defect is apparent when the product is opened, it is imperative that the device not be used and that the nature of the defect, part numbers and batch numbers of the components concerned are re-ported to the distributor or to Anthogyr. The technical specifications contained within these instructions are pro-

vided for indicative purposes only and cannot form the subject of any complaint.

The Axiom® Multi Level® implant system must not be used on animals.

Single-use devices must not be reused, or resterilised (risk of contamination and risk of alteration of functional surfac-

es).

The instructions for use here in may only be reproduced or disseminated with prior approval from the Anthogyr compa-ny. Anthogyr reserves the right to vary the technical feature of its products and/or to make changes or improvements to

the Axiom® Multi Level® system without prior notice.

The Axiom® Multi Level® implant system is not compatible with other Anthogyr and competitors’ systems.

If uncertain, the user should contact the Anthogyr company before use.

This manual cancels and replaces all previous versions.

Device sterilised by

Gamma irradiation

Manufacturing batch

number of the device

Commercial part number

of the device

Manufacturing date

of the device

Expiration date of

the device

Warming: observe

instructions for use

Non-sterile device

Sterilise by autoclave outside

of packaging

Do not sterilise

by autoclaving

Do not re-use,

single use device

Protect from light

Do not use

if packaging is damaged

Keep dry

Temperature restrictions

Manufacturer

Class I or Class IIa/IIb medical device

complying with European Directive 93/42 CEE

Tightening torque

GTIN Global Trade Item Number

S

B

O

N

g

F

V

E A

ù

X

W

n G/K

Z

Y

15°C

30°C

k

6

TABLE OF CONTENTS

Axiom® Multi Level® 8

1. Presentation of the range 9

2. Connections 10

Prosthetic ancillary 11

1. Prosthetic kit 11

2. Axiom® BL abutment extractor and gripper 12

Prosthesis on Axiom® BL 14

1. Summary of Axiom® BL prosthetic components 14

2. Healing management 15

A/ CONSTANT EMERGENCE PROFILE 15

B/ CLOSING THE AXIOM® BL IMPLANT 16

3. Single prosthesis 18

A/ IMPRESSION 18

B/ TEMPORARY PROSTHESIS ON IMPLANT 22

C/ PROSTHESIS ON AESTHETIC TITANIUM ABUTMENTS 24

D/ STANDARD TITANIUM ABUTMENTS 26

E/ PROSTHESIS ON LABORATORY BASIS 28

F/ PROSTHESIS ON COMPATIBLE CEREC® BASIS 29

G/ PROSTHESIS ON OTHER ABUTMENTS 30

4. Multiple-unit prosthesis 34

A/ MULTIPLE-UNIT PROSTHESIS ON INLINK® ABUTMENTS 34

B/ MULTIPLE-UNIT PROSTHESIS ON MULTI-UNIT ABUTMENTS 36

C/ CEMENTED MULTIPLE-UNIT PROSTHESIS 49

5. Removable prosthesis with attachments 50

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Component part numbers 72

1. Axiom® BL Cover screw / Healing screw 72

2. Axiom® TL Closure screw / Healing screw 73

3. Axiom® BL prosthetic components 73

4. Axiom® TL single-unit prosthetic components 84

5. InLink® prosthetic components 84

6. Axiom® mandrels and wrenches 86

7. Axiom® TL single-unit laboratory components 88

8. InLink® laboratory components 89

Cleaning and sterilisation 71

Disassembling - Re-assembly 71

Prosthesis on Axiom® TL 53

1. Axiom® TL range of prosthetic components 53

2. Healing management 54

3. Single-unit prosthesis 56

A/ IMPRESSION 56

B/ INDEXED TEMPORARY PROSTHESIS 57

C/ INDEXED PERMANENT SINGLE-UNIT RESTORATION 58

4. InLink® multiple-unit prosthesis 59

A/ IMPRESSION 59

B/ INLINK® TEMPORARY PROSTHESIS 60

C/ INLINK® PERMANENT PROSTHESIS 62

D/ SPECIFIC INLINK® ACCESSORIES 65

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In their quest for increasingly reliable, accessible and relevant solutions, the Antho-gyr teams have devised a way to bring even more added value to your implantology practice, without compromising on the benefits of products already in use, tested and

appreciated

From this research comes a new range of products: Axiom® Multi Level®

In perfect harmony as a continuation of everything Anthogyr has offered until now,

Axiom® Multi Level® expands the range of possibilities with total compatibility be-

tween Bone Level and Tissue Level philosophies.

Axiom® Multi Level®

A T

L

A B

L

9


A/ TERMINOLOGY Axiom® BL: Axiom® Bone Level REG: Regular

Axiom® TL: Axiom® Tissue Level PX: Post extractionnel

We have added colour coding on the Anthogyr implant box to quickly identify Tissue Level (green) and Bone Level (pink).

A B

L

A T

L

Axiom® BL REG Axiom® BL PX

Axiom® TL REG Axiom® TL PX

Neck

Body

Platform

Platform Ø

Body Ø

Base of neck Ø

Body

Body Ø

Apex

Apex

Axiom® TL implant label example Axiom® BL implant label example

1. Presentation of the range

B/ COLOR CODE

Color codes

3,4 4,0 4,6 5,2 Implant Ø

10

A T

L

2. Connections A/ AXIOM® BL

A B

L

With its single diameter 2.7mm prosthetic connection, the Axiom® BL prosthetic range is compatible with all Axiom® BL REG and Axiom® BL PX implants, regardless

of the chosen implant diameter.

2.7mm diameter emergence prosthetic. Extended, indexed, tri-lobe Morse-taper connection M1.6 threading Filet M1.6

The Axiom® TL implant has two connections:

B/ AXIOM® TL

inLink® connection

Indexed tri-lobe M1.6 connection

• INLINK® CONNECTION:

For plural screw-retained restorations 2 platform diameters: R: Ø4.8 / N: Ø4.0 Flat, non-indexed connection

M2.8 threading

• INDEXED M1.6 CONNECTION:

For single-unit screw-retained restorations Tri-lobed indexed connection 2 platform diameters: R: Ø4.8 / N: Ø4.0

M1.6 threading

BL implant

Denture prothesis

Titanium Abutment

Axiom® BL M1.6 Screw

TL implant

Prothesis

Retaining ring

Lock (guiding)

TL implant

Prothesis

Axiom® TL M1.6 Screw

11


WARNING ! Before the first and after each subsequent procedure, all of the instrument and instrument supports must be pre-

disinfected, cleaned, decontaminated and sterilised following a specific procedure

The prosthetic tool set (Ref. INMODOPP3) contains empty grommets and may be completed with optional instruments (see

catalogue p. 89)

The XL hexagonal wrenches must be placed in the areas indicated with a (*) in the photo

Dynamometric ratchet wrench: torque values (N.cm) 15/25/35. Precision (N.cm)

+/- 2.

Instructions for use available on request.

TECHNICAL SPECIFICATIONS

The kit is designed using medical grade materials enabling it to tolerate heat

disinfection and autoclave sterilisation.

The protective covers provide flexibility when positioning the kit in order to opti-

mise instrument accessibility.

Multi-Unit mandrel,

straight

Hexagonal mandrels

short and long

Multi-Unit wrench,

straight

Dynamometric ratchet

wrench

Hexagonal wrenches

short and long

* *

A T

L

Prosthetic ancillary

1. Prosthetic kit

A B

L

inLink® abutment implant wrench, short

and long

inLink® abutment implant mandrels,

short and long

Ball mandrels, short

and long

Ball wrenches, short

and long BL abutments Extrac-

tor-Gripper

12

Indications: Removal of temporary, standard and aesthetic abutments of the Axiom® BL range

Features: Available in two lengths: short and long

It allows the removal of abutments without dam-aging the implant-prosthesis connection or applying

pressure on the connection.

can be used in the dental surgery or laboratory

May be used only with Axiom® BL abutments marked with the words

“Extractible-Removable” on the traceability label.

Description:

Protocol: Fit the rod inside the body of the extractor and screw in the wheel, leaving a gap of 2mm (approx.)

between the head of the extractor and the wheel

Screw the instrument into the abutment using the body

of the extractor.

Screw in the wheel until it is resting on the body of

Abutment extractor body

Rod of the extractor 2mm

INEXPS INEXPL

Abutment extractor

Wheel

Abutment extractor body

Rod of the extractor

Hole for securing the instrument

Example label for a standard Ø5.0, abutment with a gingival height of 3.5 and crown height of 6mm

2. Axiom® BL abutment extractor and gripper

A B

L

A/ EXTRACTOR FUNCTION

13


the extractor so that the abutment can be removed.

Unscrew the abutment using the extractor body.

To clean the instrument, disassemble by unscrewing the body of the extractor and the rod. Information on the cleaning protocol, please refer to the Cleaning and Sterilisation User Guide. (063NETT-STE_NOT)

Code IFU: INMODOPS3

Features: enable abutment placement in the mouth, including areas that are difficult to access

Only the body of the extractor is used to apply this gripping function

Protocol: Screw the body of the extractor into the abutment

Position the abutment on the implant using the ex-tractor

Unscrew the abutment extractor.

A B

L

B/ GRIPPING FUNCTION

Abutment gripper

14

The Axiom® BL prosthetic range is common to implants Axiom® BL with REG profile and PX profile.

The prosthetic range of the Axiom® BL dental implant system is comprehensive. It allows the making of single-unit or

multiple-unit, cemented or screw-retained prostheses, as well as the overdenture stabilisation.

With its unique prosthetic connection (Ø 2.7 mm), the Axiom® BL prosthetic range is compatible with all Axiom® BL with

REG profile and PX profile, except for Axiom® 2.8.

In order to optimise aesthetics, the abutments are available in several emergence profile diameters, calibrated on the diameters of the healing screws. The previous table « selection of the healing screw » (Cf. p.17), provides guidelines for

the selection of the appropriate diameter.

Some prosthetic components such as the standard titanium abutments (cemented prosthesis) and conical abutments

(screw-retained prosthesis) are supplied sterile for immediate, final placement in the mouth.

Reduced handlings helps not only to preserve peri-implant tissue but also to shorten the treatment time.

Prosthesis on Axiom® BL

A B

L

IMPRESSION TEMPORARY PERMANENT

Po

p-in

Tra

ns

fers

Pick

-up

Tra

ns

fers

Tra

ns

fer co

pin

g fo

r

sta

nd

ard

ab

utm

en

ts

He

alin

g s

crew

s

Te

mp

ora

ry ab

utm

en

ts

Mu

lti-Un

it tem

po

rary

cop

ing

Ae

sth

etic a

bu

tme

nts

Sta

nd

ard

ab

utm

en

t

Go

ld-ca

st-o

n a

bu

tme

nt

Re

wo

rka

ble

ab

utm

en

t

Fle

xib

as

e

Ce

rec

® b

as

is

Mu

lti-Un

it ab

utm

en

ts

Pa

cific sys

tem

on

Mu

lti-Un

it na

rrow

LO

CA

TO

R®

ab

utm

en

ts

inL

ink

® a

bu

tme

nts

Indications

Single-unit X X X X X X X X X X X

Multiple-unit X X X X X X X X X X X X

Full-arch X X X X X X

Restoration

Sealed X X X X X X X X X X

Screw-retained X X X X X X X X X X X

Amovible X X X

Specificity

Supplied sterile X X X X X

Removable X X X X X

Material

Titanium X X X X X X X X X X X X X X

Gold cast-on X

PMMA X

PEEK X

Page 18 18 21 16 22 39/43 24 26 30 32 28 29 37/42 47 50 34

1. Summary of Axiom® BL prosthetic components

15


WARNING ! The emergence profile must not be altered in order to maintain the surface state of the gingiva. All final components

assembled on the implant are fixed by tightening to 25 N cm, except the healing screws and closure screw (manual tight-ening

16

A B

L

B/ CLOSING THE AXIOM® BL IMPLANT Indication: Cover and healing screws to close Axiom® BL implants.

Features: Cover and healing screws are delivered Q for single use.

EQUIPMENT REQUIRED

THE COVER SCREW

The cover screw is delivered with each Axiom® BL implant. It is only available in one design.

OPIM100

THE HEALING SCREW

Catalogue p. 72

Choose the healing screw from among 5

available gingival heights (0.75, 1.5, 2.5, 3.5,

and 4.5 mm), 4 emergence profile diameters

(3.4 / 4.0 / 5.0 / 6.0 mm) and 2 possible

cornal heights.

For details, see the following table with emergence profiles as a function of the

restoration.

The laser markings present on the head of the healing screws identify the diameter (4/5/6), the gingival height (line), and whether it is a

high or flat (F) version.

Healing screw sterile delivered for a single

use.

Put the screw in place with

the manual surgical wrench. (Moderate manual tightening

17


A B

L

• POSITIONING THE HEALING SCREW AND SUTURING

• PROSTHETIC DIAMETER ADAPTED TO THE SIZE OF THE TOOTH TO RESTORE

Source: Lavergne, Bulletins et Mémoires de la société d’Anthropologie de Paris, vol 1, serie XIII, 1974, 351-355. Legend:

• 1st choice • another possibility

Put the screw in place with


18

POP-IN TRANSFER

Indications: Closed impression tray on Axiom® BL implant

PICK-UP TRANSFER

Indications: Open impression tray on Axiom® BL implant

Features: Delivered non sterile

Single use

EQUIPMENT REQUIRED

EQUIPMENT REQUIRED

• IMPRESSION-TAKING:

Remove the healing screw using the long hexagonal wrench.

Insert the Pick-up or Pop-in transfer into the implant and tighten

the transfer screw (moderate manual tightening).

Take an impression using a closed impression tray (Pop-in tech-

nique) or open impression tray (Pick-up technique).

Re-insert the healing screw in situ or make a temporary pros-

thesis using the temporary abutment (see p.22).

OPPI100S / OPPI100

PICK-UP

or

POP-IN

Hexagonal wrenches

INCHECV-INCHELV-INCHEXLV

Implant analog

OPIA100

Pop-in transfer

OPPI100-OPPI100S

3. Single prosthesis

A/ IMPRESSION

a/ IMPRESSION OF THE IMPLANT A B

L

OPPU100 / OPPU100L

Pick-up transfer

OPPU100-OPPU100L

19


• IMPRESSION TRANSFER AND FASHIONING THE MASTER MODEL: Place the analogue on the transfer coping and tighten the transfer coping screw manually or with a hexagonal wrench

(moderate manual tightening

20

EQUIPMENT REQUIRED

PROTOCOL FOR USE

Remove the healing screw (or temporary abutment) using the hexagonal wrench.

Apply the impression ring corresponding to the emergence profile selected for a Pick-up New Design transfer (Ref. OPPU100 or OPPU100L). The impression ring must be in contact with the first transfer fin (see diagram below with Pick-up (Ref. OPPU100). Place the Pick-up transfer in the implant and tighten the transfer screw (manual tightening). A reference

marker should be used to check the correct position of the transfer in the implant.

Take the impression using an open block plate.

Replace the healing screw or temporary abutment

Landmark visible if the transfer is set up correctly.

OK

NO

Hexagonal wrenches


Pick-up Transfer

Transfer screw

OPPU100

Pick-up Transfer L

Transfer screw

OPPU100L

Impression rings Ø4.0 and Ø5.0

Catalogue p.74

A B

L

21


IMPRESSION TRANSFER

Indications: Closed impression tray on standard titanium abutment

Features: Single use The impression coping is supplied clean and non-sterile, it must be cleaned and sterilised before its first use.

USER PROTOCOL

Place the impression transfer on the top of the standard

titanium abutment.

Maintain slight pressure, applying rotation to index the

transfer with the abutment.

Once the indexation is in place, press the transfer onto the

non-re-worked abutment until it clicks.

Take a conventional impression using a standard impres-

sion tray.

Once the impression has been taken, close the access cavity

with filling material after protecting the screw head.

.

MASTER MODEL AND PROSTHESIS

Insert the abutment analog in the transfer into the impres-sion intrados (until a click is heard) after visualising the rela-

tive position of the analog in the impression.

Check that the analog is correctly fixed in the impression (if

necessary, repeat the procedure) and pour the master model.

c/ IMPRESSION ON STANDARD ABUTMENTS

OPTT100

A B

L

22

B. TEMPORARY PROSTHESIS ON IMPLANT

TEMPORARY ABUTMENTS

Indications: Single-unit or multiple-unit temporary restoration on Axiom® BL implant

Catalogue p.75

Features: Recommended for use as screw-retained prosthesis. The coronal surface of the abutment allows a resin to adhere for temporary restoration. Hold can be increased by light transverse grooves or by sanding. The recommended tightening torque for the abutment fixation screw is 25 N.cm. The abutment is inserted into the

implant with indexation for fast and easy positioning into the implant.

Removable using the abutment extractor instrument. (see p.12)

CHOICE OF ABUTMENT

Select the abutment from the 5 available gingival heights (0.75, 1.5,

2.5, 3.5 and 4.5 mm) and the 4 emergence profiles (3.4 / 4.0 / 5.0 / 6.0

mm).

The abutment is ideally chosen depending on the emergence profile.

NOTE: try-in abutments are also available to help in the choice of gin-

gival height.

EQUIPMENT REQUIRED

EMERGENCE PROFILE

Ø3.4 Ø4.0 Ø5.0 Ø6.0

Hexagonal mandrels

INMHECV-INMHELV-INMHEXLV

Hexagonal wrenches


M1.6 prosthetic screw

OPTS161

Laboratory screw

OPTS162

A B

L

23


n

USER PROTOCOL

• CONNECTING THE ABUTMENT: Connect the temporary abutment onto the implant with the short M 1.6 laboratory screw and the long hexagonal wrench

(moderate manual tightening).

Proceed to the abutment modification.

Replace the short M 1.6 screw by the long M 1.6 laboratory

screw. Tighten manually with the short hexagonal wrench.

• PERFORMING THE TEMPORARY RESTORATION: Fill the plastic mold or pre-perforated thermo-tray with

acrylic resin.

Cover the abutment (leaving the laboratory screw emerging

through the opened thermo-tray).

Polymerise the resin or leave it to harden.

• REMOVING THE TEMPORARY RESTORATION AND MAKING ADJUSTMENTS:

Remove the laboratory screw.

Remove the thermo-tray with the resin and the tem-porary

abutment.

Separate the temporary restoration from the thermo-tray.

Make the final adjustments and polish.

• CONNECTION THE TEMPORARY: Reposition the temporary prosthesis with the M1.6 fixation

screw (supplied with the temporary abutment).

A retro-alveolar X-Ray may help to confirm complete con-nection between the implant and the standard titanium abut-

ment.

Tighten at 25 N.cm using the dynamometric ratchet wrench and the hexagonal wrench or the TORQ CON-

TROL® and hexagonal mandrels.

Close the access cavity(ies) with filling material after pro-tecting the head of the screw.

WARNING ! When immediate loading procedure is not planned, it is essen-tial to position the temporary prosthesis in sub-occlusion pen-ding the final prosthesis, in order to ensure integrity of the

device.

A B

L

24

C. PROSTHESIS ON AESTHETIC TITANIUM CORE ABUTMENTS

AESTHETIC ABUTMENTS

Indications: Single-unit or multiple unit cement retained restoration on Axiom® BL implant

Catalogue p.76

Features: The aesthetic titanium abutment is supplied decontaminated and non-steriled with its fixation screw. The impression is taken directly at the implant level by taking a Pick-up or Pop-in impression. The prosthesis and any re-working on the abutment are per-formed in the laboratory.

The recommended tightening torque for the aesthetic titanium abutment fixation screw is 25 N.cm. Removable: Designed with a specific inner threading compatible with the Abutment extractor instrument (see p. 12)

SELECTION OF ABUTMENT

Select the abutment from the 5 gingival heights (0.75, 1.5, 2.5,

3.5 and 4.5 mm), the 4 prosthesis emergence profiles (3.4, 4.0,

5.0 and 6.0 mm) and 4 coronary angulation (0°, 7°, 15° and 23°) available. Ideally, the abutment is chosen de-pending on the healing screw in situ, observing the concept of preserving the

emergence profile.

NOTE: Try-in abutments are available to facilitate the choice of the abutment. Straight and angulated abutments follow the same protocol of use. When using aesthetic abutments, take into con-

sideration the implant orientation.

NOTE: AESTHETIC titanium abutments with Gh 4.5mm have a specific gingival profile to be used in the following situa-tions: - Gingival height of 4.5 mm and coronary height of 7 mm. - Gingival height of 2.5 mm and coronary height of 9 mm.

EQUIPMENT REQUIRED

Ø 3.4 Ø 4.0 Ø 5.0 Ø 6.0

EMERGENCE PROFILE

Hexagonal wrenches



OPTS161

M1.6 Black Tite®

prosthetic screw

OPTS160

Implant analog

OPIA100

A B

L

Hexagonal mandrels


25


n

USER PROTOCOL

Take an impression (see p.18)

• THE PROSTHESIS: Insert the aesthetic titanium abutment fully into the analog in the correct orientation and tighten it with the laboratory

M1.6 fixation screw.

Adapt abutment by drilling and fashion the definitive pros-

thesis.

• PLACING THE ABUTMENT: Insert, indexing the abutment into the implant in the correct

orientation and screw the Black Tite® M1.6 fixation screw sup-

plied.

A retro-alveolar x-ray may be performed to confirm that the

abutment is completely connected to the implant.

Tighten at 25 N.cm using the dynamometric ratchet

wrench or TORQ CONTROL®.

• RESTAURATION: Close the access cavity(ies) with a filling material after pro-

tecting the screw head.

Cement the crown definitively onto the abutment in the

mouth.

A B

L

26

D. STANDARD TITANIUM ABUTMENTS

STANDARD ABUTMENTS

Indications: Single-unit or multiple-unit sealed restoration on Axiom® BL implants

Catalogue p.77

Features: The standard titanium abutment is supplied decontaminated and sterilised with its fixation screw for direct placement in the mouth. The impression is taken from the abutment in order to reduce the parodontal manipulations.

The recommended tightening torque for the standard titanium abutment fixation screw is 25 N.cm. Removable using the abutment extractor instrument. (see p.12)

WARNING ! Do not re-work the abutment, in order not to compromise the impression taking. If re-working is performed, take the conventional impression directly on the implant or take a conventional impression onto abutment.

CHOIX DU FAUX MOIGNON

Select the abutment from the 3 gingival heights (1.5, 2.5 and 3.5 mm),

the 2 coronary heights (4.0 and 6.0 mm) and the 2 possible angles of

angulated abutment non indexed (15°and 23°) available.

The abutment is ideally chosen depending on the healing screw in situ and observing the concept of emergence profile preservation. Select the

abutment in order that no re-working is required.

NOTE: try-in abutments are available to facilitate the choice of the abut-ment. Straight and angulated abutments follow the same protocol of use. When using angulated abutments, take into consideration the im-

plant orientation.

EQUIPMENT REQUIRED

Protective cap

Catalogue p.78

Abutment analog

Catalogue p.78

Rotational and non-rotational castable

caps

Catalogue p.79

Ø 3.4 Ø 4.0 Ø 5.0 Ø 6.0

EMERGENCE PROFILE

A B

L

Hexagonal wrenches

INCHECV-INCHELV INCHEXLV

M1.6 Black Tite®

prosthetic screw

OPTS160

Hexagonal mandrels


27


n

USER PROTOCOL

• CONNECTING THE ABUTMENT: Remove the healing screw using the long hexagonal

wrench.

Insert the standard titanium abutment selected fully into the

implant and tighten the M1.6 Black Tite® fixation screw provid-

ed.



Tighten at 25 N.cm using the dynamometric ratchet wrench and the hexagonal wrench or the TORQ CON-

TROL® and hexagonal mandrels.

• PROTECTING THE ABUTMENT AND TEMPORARY PROS-THESIS:

Clean the abutment thoroughly.

Temporarily seal the protection cap after protecting the

screw head. This can also be used to make a temporary tooth.

Thoroughly remove excess cement.

• PROSTHESIS:

Take an impression (see p. 18)

Fashion the metal frame using the castable coping. Cover the analog’s crown with spacer (necessary to stabilise the

castable coping).

Prepare the final prosthesis according to current restora-

tion protocols.

Close the access cavity(ies) with a filling material after pro-


Cement the crown with temporary cement onto the abutment

in the mouth.

Thoroughly remove excess cement. Risk of complications

that may result in loss of implant.

NOTE: rotational or anti-rotational castable copings are availa-ble depending on the cement retained prosthesis (for multiple

or unit procedures respectively).

A B

L

E

28

E. PROSTHESIS ON LABORATORY BASIS

n

FLEXIBASE AXIOM®

Indications: Single-unit screw-retained restoration on Axiom® BL implants

OPFLEX403 / OPFLEX503

Features: The basis is delivered decontaminated and non sterile with its fixing screw.

The basis must not be altered (either on the gingival part or the coronary part).

Any alteration risks weakening the mechanical structure of the part. The coronary part will only tolerate corundum blasting (Al203) with a granulometry between 50μm

and 125μm and with pressure of 2 to 4 bars where blasting is required by the manu-

facturer of the adhesive materials.

Recommended tightening for the titanium base screw is 25 N.cm.

Removable: Designed with a specific inner threading compatible with the Abutment extractor instrument (see p. 12)

CHOICE OF THE BASIS

Flexibase Axiom® basis are used in the laboratory to create single-tooth abut-

ments and screw-retained dentures. They can be selected from two possible

diameters (4.0 / 5.0 mm).

USER PROTOCOL

Create the suprastructure using CAD-CAM machining or with a casting technique. Check the manufacturer’s recom-

mendations for the restoring materials regarding the minimum thickness of the suprastructure. For Zirconium ma-

chining, the thickness of the suprastructure's walls must be greater than or equal to 0.4mm.

Assemble the basis using the suprastructure to create the prosthetic restoration. Check the manufacturer’s recom-

mendations for the adhesive materials regarding bonding protocol. For bonding a ZIRCONIA suprastructure, Anthogyr recommends the use of the following adhesives: MULTILINK AUTOMIX by IVOCLAR VIVADENT or PANAVIATM F2.0 by KU-

RARAY DENTAL.

Clean and sterilise the prosthetic restoration and fixing screw M1.6 (provided with the basis).

Screw the prosthetic restoration onto the implant using the fixing screw M1.6 to 25N.cm using the dynamometric

instrument (Ref. INCCD) or TORQ CONTROL®.

Close the access channel with filling material after protecting the screw head.

Ø4.0 Ø5.0

Flexibases Axiom®

A B

L

EMERGENCE PROFILE

Ø 5.0

OPFLEX503

Ø 4.0

OPHS410 or

OPHSF410

OPHS510 or

OPHSF510

OPFLEX403

29


F. PROSTHESIS ON COMPATIBLE CEREC® BASIS

A B

L

n

AXIOM® - S TIBASE L

Indications: Single-unit screw-retained restoration on Axiom® BL implants

OPBASE-S45

Features: The basis is delivered decontaminated and non sterile with its fixing screw.

The basis must not be altered (either on the gingival part or the coronary part). Any al-

teration risks weakening the mechanical structure of the part. The coronary part will only tolerate corundum blasting (Al203) with a granulometry between 50μm and 125μm and

with pressure of 2 to 4 bars where blasting is required by the manufacturer of the adhe-

sive materials.

Recommended tightening for the titanium base screw is 25 N.cm.

The Axiom® – S Tibase L basis is compatible only with size L machining blocks marketed by Sirona™.

Removable: Designed with a specific inner threading compatible with the Abutment extractor instrument (see p. 12)

CHOICE OF THE BASIS

The Axiom® – S Tibase L basis is made of a coronary part that is compatible with the CEREC® digitised caps and machine attachments marketed by Siro-

na™.

USER PROTOCOL

Create the suprastructure according to the instructions for use provided with the materials marketed by Sirona™.

Screw the prosthetic restoration onto the implant using the fixing screw M1.6 to 25N.cm using the dynamometric

instrument (Ref. INCCD) or TORQ CONTROL®.

Close the access channel with filling material after protecting the screw head.

Ø4.5

Axiom® - S Tibase L

EMERGENCE PROFILE

Ø 4.0

OPHS410 or

OPHSF410

OPBASE-S45

30

G. PROSTHESIS ON OTHER ABUTMENTS

a/ GOLD CAST-ON ABUTMENT

Hexagonal wrenches


STANDARD ABUTMENT

Indications: Single-unit screw-retained restoration or multiple-unit cement retained restoration on Axiom® BL implants

OPOG110

Features: The gold cast-on abutment is supplied with its fixation screw. One single emergence profile available with the gold cast-on abutment (4.0 mm). Technical specifications: - composition CERAMICOR®: Au 60 % / Pd 20 % / Pt 19 % / Ir 1 %. - melting interval: 1400°C – 1490°C. Contact: Cendres + métaux SA - Phone +41 58 360 20 00 - Fax +41 58 360 20 10

The impression shall be taken at the implant level.

The abutment is re-worked and the prosthesis is made only in the laboratory.

The recommended tightening torque for the gold cast-on abutment fixation screw

is 25 N.cm.

EQUIPMENT REQUIRED

USER PROTOCOL


Recommendation

The single size of the gold cast-on abutment has a single di-mension of healing screw. Observe the concept of preservation

of the emergence profile.

• MAKING THE PROSTHESIS: Insert the gold cast-on abutment into the analog and tight-

en the laboratory M1.6 fixation screw.

Adjust the castable sleeves in order to recreate a custom-

ized abutment by drilling and/or adding calcinable resin (wax).

NOTE: use the M1.6 long laboratory screw to preserve the

screw spirals when adding resin.

M1.6 Black Tite®

prosthetic screw

OPTS160

Ø 4.0 H1.5

EMERGENCE PROFILE

A B

L

Hexagonal mandrels


M1.6 prosthetic

screw

OPTS161

Implant analog

OPIA100

Laboratory screw

OPTS162

31


n

• FASHIONING THE ABUTMENT AND DEFINITIVE CROWN: Carefully remove the personalised gold cast-on abutment

from the master model.

Mold the abutment following the material manufacturer’s

recommendations and using the current coating procedure.

Replace the abutment on the master model with the M1.6 fixation screw in the correct orientation and make the definitive

prosthesis.

• PLACING THE ABUTMENT: Insert, indexing the gold cast-on abutment into the implant

in the correct orientation and screw the Black Tite® M1.6 fixa-

tion screw supplied.




wrench or TORQ CONTROL®.

• RESTORATION: Close the access cavity(ies) with a filling material after pro-



mouth.



A B

L

E

32

b/ REWORKABLE ABUTMENT

FAUX-MOIGNON À TAILLER

Indications: Single-unit or multiple-unit cement retained restoration on Axiom® BL implants

OPFS100

Features: The reworkable abutment is delivered decontaminated and non-sterile with its fixation screw. The impression shall be taken at the implant level. The abutment is reworked and the prosthesis is made only in the laboratory (recommended minimum residual thickness: 0.5 mm). The recommended tightening torque for the reworkable abutment fixation screw

is 25 N.cm.

EQUIPMENT REQUIRED

USER PROTOCOL


• MAKING THE PROSTHESIS:

Insert the reworkable abutment into the analog, correctly

orienta-ting it and screw the laboratory M1.6 fixation screw.

Size the reworkable abutment by drilling (fine 30μm dia-

mond tipped drill bit on multiplier contraangle at 150,000-

200,000 rpm under irriga-tion) directly on the master model

(keep minimum 0.5 mm material).

Make the definitive prosthesis.

Ø 4.0 H1.5

EMERGENCE PROFILE

A B

L

Hexagonal wrenches


M1.6 Black Tite®

prosthetic screw

OPTS160

Hexagonal mandrels



OPTS161

Implant analog

OPIA100

33


n

• PLACING THE ABUTMENT: Insert, indexing the reworkable abutment into the implant in

the correct orientation and tighten the Black Tite® M1.6 fixa-

tion screw supplied.




wrench or TORQ CONTROL®

• RESTORATION: Close the access cavity(ies) with a filling material after pro-



mouth.



A B

L

E

34

n

WARNING ! The inLink® abutments can only be implanted on sufficiently stable implants. They cannot be used for single-unit restorations.

INLINK® ABUTMENT

Indications: Multiple-unit inLink® screw-retained restoration on Axiom® BL implant

Catalogue p.79

Features: These abutments allow to fit the inLink® connection on an Axiom® BL implant A multiple-unit inLink® prosthesis may be built on a combination of Axiom® BL with inLink® abutments and Axiom® TL. The inLink® abutment is supplied clean and sterile.

The recommended tightness of the inLink® abutment is 25 N.cm.

CHOIX DU PILIER

Choose inLink® abutments between the 2.5 and 3.5 mm heights and 2 plat-

form diameters available (N: Ø 4.0 and R: Ø 4.8). Ideally, the gingival height of the inLink® abutment will match the gingival height available. The healing stage can also be completed directly with the inLink® abut-ment with its closure screw (Ref. TSS-N0 or TSS-R0) or TL healing screw (see p. 54)

EQUIPMENT REQUIRED

MISE EN PLACE DU PILIER

Insert the inLink® abutments in the Axiom® BL im-plants.

Tighten to 25 N.cm with a prosthetic torque wrench (Ref. INCCD) and an implant wrench (Ref. TIW100-S or TIW100-L) or TORQ CONTROL® and an implant mandrel (Ref. TIM100-S or TIM100-L).

Implant mandrels

TIM100S-TIM100L

4. Multiple-unit prosthesis

A/ MULTIPLE-UNIT PROSTHESIS ON INLINK® ABUTMENTS

A B

L

Implant wrench

TIW100S-TIW100L

Platform N: Ø 4.0

H 2.5 H 3.5

H 2.5 H 3.5

or

Platform R: Ø 4.8

35


A B

L IMPRESSION

See Chapter “impression on inLink® multiple-unit prosthesis” (p. 59)

TEMPORARY PROSTHESIS

See Chapter “inLink® temporary prosthesis” (p. 60)

PERMANENT PROSTHESIS

See Chapter “inLink® permanent prosthesis” (p. 62)

ACCESSORIES

See Chapter “Specific inLink® accessories” (p. 65-70)

36

The Multi-Unit Axiom® BL abutment range incluses: Straight and angled abutments with COMMON platform 4.8 mm and

auxiliary components that can be used with both versions.

Straight abutments with a NARROW platform 4.0 mm and dedicated

auxiliary components.

Features: The recommended torque for 4.8 mm and 4.0 mm Multi-Unit abut-

ments is 25 N.cm Connection of angled Multi-Unit abutments to Axiom® BL implants is performed using a dedicated Multi-Unit M1.6 fixation screw. All Multi-Unit abutments come with their attached Multi-Unit manipu-

lation tool for easy placement.

Description:

Ø 4.8 mm and 4.0 mm straight Multi-Unit abutments should be tightened at 25 N.cm

either with the Multi-Unit mandrel (Ref. MUM100) or the Multi-Unit wrench (Ref. MUW100).

Connection of temporary or permanent auxiliary components to Multi-Unit abutments requires the use of the dedicated

Multi-Unit M1.4 fixation screws using a torque of 15 N.cm. Protective caps must be hand tightened. Multi-Unit M1.4 fixa-tion screws are compatible with both 4.8 mm and 4.0 mm platforms. A color coding system is used for all auxiliary com-

ponents for 4.8 mm and 4.0 mm Multi-Unit abutments:

Laboratory screws (Multi-Unit titanium M1.4 screws and Multi-Unit laboratory screws)

for use with 4.8 mm and 4.0 mm Multi-Unit abutments: Blue color code.

Components for use with 4.8 mm Multi-Unit abutments: Yellow color code on whole or part of the component.

Components for use with 4.0 mm Multi-Unit abutments: Green color code on whole or part of the component.

Components for 4.0 mm Multi-Unit abutments are lasermarked « N » for « Narrow ».

Ø 4.8

B. MULTIPLE-UNIT PROSTHESIS ON MULTI-UNIT ABUTMENTS Ø 4.0

Multi-Unit

COMMON platform

Ø4.8 mm

Multi-Unit

NARROW platform

Ø4.0 mm

n Ø = 4.8 mm

Ch = 2.5 mm

Gh

COMMON platform Ø 4.8 mm

Ch = 2.5 mm

Ø = 4.8 mm

Gh

20°

Ø = 4.0 mm

n Ch = 1.5 mm

GH

NARROW platform Ø 4.0 mm Ref. OPMU160

A B

L

a/ PRESENTATION OF THE RANGE

37


MULTI-UNIT Ø4.8 ABUTMENTS

Indications: Multiple-unit screw-retained restorations on Axiom® BL implants

Catalogue p.80

Features and instructions for use: The angulated Multi-Unit abutments are screw-down, the fixing screw on the implant (Ref. OPMU160) is packaged with the abutment. Multi-Unit Ø 4.8 mm abutments (straight and angulated) and Multi-Unit protection caps are supplied sterile for direct placement during surgery. Multi-Unit abutments are supplied with a Multi-Unit pre-assembled holder to facilitate the placement of the abut-ments. The pre-assembled holder should be removed after placement.

The recommended tightness of the fixing screw of Multi-Unit abutments (straight and angulated) is 25 N.cm.

The recommended tightness for the secondary components is 15 N.cm. In case of Axiom® BL healing screw placement before Multi-Unit common platform Ø 4.8 abutment placement, it is recommended to use a Ø 5.0 mm healing screw in order not to compress the gum during the abutments placement. When using OPMU0-4 abutments, a healing screw Ref.OPHS530 may be used during the healing phase. When the laboratory realises a multiple-unit prosthesis from a master-model with implant analogs, he must use Mul-ti-Unit Blue M1.6 screws (Ref. OPMU161) supplied unitary. Complete tooth restoration may be considered immediately after placement of a small number of Axiom® BL im-plants provided.

SELECTION OF THE APPROPRIATE MULTI-UNIT ABUTMENT

Both straight and angled multi-unit abutments are available.

STRAIGHT MULTI-UNIT ABUTMENT: For a 4.8 mm platform, 5 gingival heights (0.75,

1.5, 2.5, 3.5 & 4.5 mm) are available.

ANGLED MULTI-UNIT ABUTMENT: For a 4.8 mm platform, 4 gingival heights (0.75, 1.5,

2.5 & 3.5 mm) and 2 angulations (18° and 30°) are available in both indexed and non-indexed versions. Two important parameters must be taken into account when selecting the appropriate gingival height for a Multi-Unit abutment: height of the inserted healing screw, and maintenance of a constant emergence profile. Alternatively, the healing phase can be managed with the Multi-Unit abutment alone, using the Multi-Unit protective cap (Ref. MUCAP).

EQUIPMENT REQUIRED

A B

L b/ MULTI-UNIT COMMON PLATFORM Ø 4.8 MM ABUTMENTS

Ø 4.8

EMERGENCE PROFILE

Handling tool Hexagonal mandrels Hexagonal wrenches Multi-Unit mandrel and

wrench Pick-up Transfer

Ø 4.8mm Pop-in Transfer

Ø 4.8mm

MUWS INMHECV-INMHELV-INMHEXLV


MUM100-MUM100L-MUW100

MUT100 MUT200

Abutment analog Ø 4.8mm

Protective analog Ø 4.8mm

Protective cap Ø 4.8mm

Temporary titanium cap Ø 4.8mm

Temporary PEEK cap Ø 4.8mm

Castable PMMA cap Ø 4.8mm

CoCr cap Ø 4.8mm

MUA100 MUA200 MUCAP MUC100 MUC200 MUC300 MUC400

38

n

n

USER PROTOCOL

WARNING ! Ensure that the Multi-Unit pre-assembled holder IS CORRECTLY placed on the Multi-Unit abutment before placing it in

the mouth.

If mouth opening is narrow, remove the pre-assembled holder supplied with the Multi-Unit abutment and use the short pre-assembled holder (Ref. MUWS)

• PLACING THE MULTI-UNIT ABUTMENT:

STRAIGHT MULTI-UNIT ABUTMENT Screw the straight Multi-Unit abutment into the im-plant using the Multi-Unit abutment pre-assembled

holder. Then, remove the pre-assembled holder.

Tighten the Multi-Unit abutment to 25 N.cm with the prosthetic torque wrench (Ref. INCCD) and the Multi-Unit wrench (Ref. MUW100) or the TORQ CONTROL®

and the Multi-Unit mandrel (Ref. MUM100 or MUM100L)

ANGLED MULTI-UNIT ABUTMENT Insert the angled Multi-Unit abutment in the correct orientation (for indexed components, select the appro-

priate position). Insert the Multi-Unit Black Tite® M1.6 fixation screw dedicated to Multi-Unit (Ref. OPMU160) using

the long hexagonal wrench

Torque the screw to 25 N.cm using either the torque wrench (Ref. INCCD) and the long hexagonal wrench, or the TORQ CONTROL® and the hexagonal

tightening mandrel. Then, remove the holder.

• IMPRESSION TAKING AND TEMPORISATION: Place a Multi-Unit Pick-up Ø 4.0 mm transfer coping (Ref. MUT100) on each Multi-Unit abutment and secure it by inserting a short or long coping screw or Multi-Unit Pop-in transfer (Ref. MUT200).and hand tightening (using mod-

erate force < 10 N.cm)

Use a closed impression tray for a Pop-In transfer impression (Pop-In technical) or an open impression

tray (Pick-up technical).

At this stage, two options are available: put the Multi-Unit protective caps (Ref. MUCAP) back into place and hand tighten them (using moderate force), or do a provisional prosthesis from the appropriate coping(s) (Cf. Tempo-

rary prosthesis ).

LABORATORY:

Screw the Multi-Unit analog (Ref. MUA100) in each

transfer

Create the master model..

A B

L

POP-IN PICK-UP

POP-IN PICK-UP

39


m

• TEMPORARY PROSTHESIS

Connect temporary copings Connect the appropriate temporary copings: Multi-Unit titanium ones (Ref. MUC100) or Multi-Unit PEEK ones

(Ref. MUC200) on Multi-Unit abutments.

Tighten the temporary caps on the straight Multi-Unit abutments with the titanium fixing screw M1.4 (Ref. MU141), the laboratory screws (Ref. MUT101 or MUT102) dedi-cated to the Multi-Unit abutments or the respective long Multi-Unit Pick-up transfer coping screws. Moderate

manual tightening (

40

m

• CAD CAM PERMANENT PROSTHESIS PERMANENT PROSTHESIS STARTING FROM 100% CASTABLE CAPS (Following impression taking and validation using a

plaster cast)

In the laboratory

Login screeds 100% castable Connect the Multi-Unit castable copings (Ref. MUC300) to the Multi-Unit abutments analogs (Ref. MUA100) in the master model using the Multi-Unit titanium M1.4 fixation screws, the laboratory screw (Ref. MUT101 or MUT102) or the corresponding Multi-Unit long pick-up transfer coping screws (hand tighten to a torque

41


m

FINAL PROSTHESIS USING A 100% COCR OVERCAST CAP

(Following impression taking and validation using a plaster cast)

Specific instructions for these caps are available on ifu.anthogyr.com. Please refer to these instructions before mak-

ing the cast. Code IFU: MUC400

In the laboratory

Connection of CoCr caps Connect the CoCr Multi-Unit caps (Ref. MUC400) to the Multi-Unit abutments analogs (Ref. MUA100) with the M1.4 Multi-Unit titanium screw, the laboratory screws or the corresponding long transfer coping screws Multi-Unit Pick-up (moderate manual tightening to

42


Indications: Plural screw-retained restorations with restricted space between Axiom® BL implants.

Catalogue p.81

Features and instructions for use: Multi-Unit Ø 4.0 mm abutments straight and Multi-Unit protection caps are supplied sterile for direct placement dur-ing surgery. Multi-Unit Ø 4.0 abutments are supplied with a Multi-Unit pre-assembled holder to facilitate the placement of the abutments. The pre-assembled holder should be removed after placement.

The recommended tightness of the fixing screw of Multi-Unit abutments (straight and angulated) is 25 N.cm.

The recommended tightness for the secondary components is 15 N.cm. In case of Axiom® BL healing screw placement before Multi-Unit narrow Ø 4.0 abutment placement, it is recommend-ed to use a Ø 4.0 mm healing screw in order not to compress the gum during the conical abutments placement. In case an abutment is placed with an H4.5 gingival height, (Ref. OPMUN0-4) using a healing screw with a 4.0 diameter and 3.5 gingival height (Ref. OPHS430). Complete tooth restoration may be considered immediately after placement of a small number of Axiom® BL implants

provided that adequate bone stock is available.

SELECTION OF THE APPROPRIATE MULTI-UNIT CONICAL ABUTMENT

STRAIGHT MULTI-UNIT ABUTMENT:

For a Ø 4.0 mm, 5 gingival heights (0.75, 1.5, 2.5, 3.5 & 4.5 mm) are available. Two important parameters must be taken into account when selecting the appropriate gin-gival height for a Multi-Unit narrow straight abutment: height of the inserted healing screw, and maintenance of a constant emergence profile. Alternatively, the healing phase can be managed with the straight conical abutment alone, using the Multi-Unit narrow protective cap (Ref. MUNCAP).

EQUIPMENT REQUIRED

Ø 4.0

EMERGENCE PROFILE

c/ MULTI-UNIT NARROW PLATFORM Ø 4.0 MM ABUTMENTS

A B

L

Handling tool Hexagonal mandrels Hexagonal wrenches Multi-Unit mandrel and

wrench Pick-up Transfer

Ø 4.0mm Pop-in Transfer

Ø 4.0mm

MUWS INMHECV-INMHELV-INMHEXLV


MUM100-MUM100L-MUW100

MUNT100 MUNT200

Abutment analog Ø 4.0mm

Protective analog Ø 4.0mm

Protective cap Ø 4.0mm

Temporary titanium cap Ø 4.0mm

Temporary PEEK cap Ø 4.0mm

Castable PMMA cap Ø 4.0mm

CoCr cap Ø 4.0mm

MUNA100 MUNA200 MUNCAP MUNC100 MUNC200 MUNC300 MUNC400

43


n

USER PROTOCOL

WARNING ! Ensure that the MULTI-UNIT pre-assembled holder IS PLACED CORRECTLY on the Multi-Unit conical abutment before

placing it in the mouth.

If mouth opening is narrow, remove the pre-assembled holder supplied with the Multi-Unit abutment and use the short pre-assembled holder (Ref. MUWS) .

• PLACING THE MULTI-UNIT CONICAL ABUTMENT:

STRAIGHT MULTI-UNIT ABUTMENT Screw the straight Multi-Unit narrow conical abut-ment into the implant using the Multi-Unit handling tool.

Then, remove the handling tool.

Tighten the Multi-Unit abutment to 25 N.cm with the prosthetic torque wrench (Ref. INCCD) and the Multi-Unit wrench (Ref. MUW100) or the TORQ CONTROL®

and a Multi-Unit mandrel (Ref. MUM100 or MUM100L)

• IMPRESSION TAKING AND TEMPORISATION: Place a Multi-Unit Pick-up Ø 4.0 mm transfer coping (Ref. MUNT100) on each Multi-Unit abutment and secure it by inserting a short or long coping screw or Multi-Unit Pop-in transfer (Ref. MUNT200).and hand tightening (using

moderate force < 10 N.cm).

Use a closed impression tray for a Pop-In transfer impression (Pop-In technical) or an open impression

tray (Pick-up technical).

At this stage, two options are available: put the Multi-Unit protective caps (Ref. MUNCAP) back into place and hand tighten them (using moderate force), or do a provi-sional prosthesis from the appropriate coping(s) (Cf.

Temporary prosthesis ).

• LABORATORY: Screw the Multi-Unit narrow Ø4.0 analog (Ref. MUNA100)

in each transfer..

Create the master model.

• TEMPORARY PROSTHESIS:

Connect temporary copings Connect the appropriate temporary copings: Multi-Unit Ø 4.0 titanium ones (Ref. MUNC100) or Multi-Unit Ø 4.0

PEEK ones (Ref. MUNC200) on Multi-Unit abutments.

Tighten the temporary caps on the straight Multi-Unit abutments with the titanium fixing screw M1.4 (Ref. MU141), the laboratory screws (Ref. MUT101 or MUT102) dedi-cated to the Multi-Unit abutments or the respective long Multi-Unit Pick-up transfer coping screws. Moderate

manual tightening (

44

m

Fabricate the provisional Fill a plastic mould or a template with acrylic resin. In the case of a template, holes must be made to allow the long pick-up transfer coping screws to pass through. Place the mould or perforated resin template over the adjusted temporary copings. Allow the resin to harden or polymerize.

Remove the provisional and make final adjust-

ments Remove the fixation screw (Multi-Unit titanium M1.4 screw, laboratory screw or Multi-Unit pick-up transfer coping screw). Remove the resin template and temporary restora-tion. Separate the temporary coping from the template. After final adjustments have been made, the provi-sional is polished. Use the protection caps.

Connect the provisional Reposition the temporary prosthesis with the M1.4 Multi–Unit titanium fixing screw supplied with the tem-

porary cap using a hexagonal wrench.

A retroalveolar X-ray is most useful to confirm proper

implant-abutment connection.

Torque to 15 N.cm using the torque wrench (Ref.

INCCD) or the TORQ CONTROL®.

WARNING ! Unless immediate loading is performed, the provisional should be placed out of occlusion so as not to compro-mise device integrity.

• CAD CAM PERMANENT PROSTHESIS PERMANENT PROSTHESIS STARTING FROM 100%

CASTABLE CAPS (Following impression taking and validation using a

plaster cast)

In the laboratory

Connection of CoCr caps Connect to the analogues of the Multi–Unit Ø 4.0 mm abutments (Ref. MUNA100) on the master model the Multi–Unit Ø 4.0 mm castable caps (Ref. MUNC300) with the M1.4 titanium Multi–Unit fixing screws or the corresponding Pick-up Multi–Unit long transfer coping screws (moderate manual tightening

45


m

Creating final prosthesis using a casting technique Create the cast according to the recommendations of the material’s manufacturer

Verification of the cast structure

Replace the cast structure over the master cast us-ing the titanium M1.4 Multi-Unit fixing screw (moderate manual tightening

46

m

Creating final prosthesis using a casting tech-

nique Create the cast according to the recommendations of the material’s manufacturer using an overcast CoCr with a melting temperature of 1338°C. The selected alloy must respect the following standards: ASTM F1537, ASTM F795, ISO 5832-12 and ISO 5832-4. Porcelain must not be placed in direct contact with the CoCr manufactured ring. The cast alloy must cover the entire CoCr cap, otherwise the porcelain may not bond properly and may crack. The thickness of the resin and the castable cap must be over 0.5mm before casting and must be resized to 0.3mm after casting.

Verification of the cast structure

Replace the cast structure over the master cast us-ing the titanium M1.4 Multi-Unit fixing screw (moderate manual tightening

47



Indications: Plural screw-retained restorations with Multi-Unit narrow platform Ø 4.0 mm abutments. .

Catalogue p.82

The Pacific is an additional system reserved exclusively for multiple-unit or full-arch screw retained prostheses on

straight conical abutments. Introducing a ring bonded between the straight conical abutment and the framework cast by

the laboratory, the Pacific system ensures the passive fit during definitive screwing in the mouth.

Features and instructions for use: The bonding ring is provided with its permanent screw M1.4 Black Tite®.

Recommended tightening torque of the screw is 15 N.cm. The bonding ring can only be used with straight conical abutments.

EQUIPMENT REQUIRED

USER PROTOCOL In the laboratory

• PLACEMENT OF THE CONICAL ABUTMENT AND IMPRESSION-TAKING Repeat steps 1 to 4 described in the paragraph « Multi-Unit

narrow platform » (Cf p. 43-44).

• MAKING THE PERMANENT PROSTHESIS:

Connect the Pacific Multi-Unit narrow analogs (Ref. MUN-PAC110) onto the conical abutments analogs using the Multi-Unit laboratory screw M1.4 (Ref. MU141), moderate manual tightening

(

48

m

• MAKING THE PERMANENT PROSTHESIS (CONTINUE):

Perform casting in compliance with the material manufac-turer’s recommendations. Proceed with the assembly and firing of the ceramic on the framework. Carry out finishing work.

Sand and clean the basal surface of the prosthesis.

• CHECKING PASSIVITY:

Unscrew the Pacific Multi-Unit narrow analogs from the

master model.

Place a Multi-Unit narrow bonding ring (Ref. MUNPAC100) into

each slot of the framework.

Position and screw the entire assembly onto the master mo-del using short or long Multi-Unit abutment pick-up screws (Ref. MUT101 or MUT102).

If any tension remains, correct the basal surface of the pros-

thesis.

Remove.

• BONDING THE PACIFIC RINGS:

Put some adhesive on the grooved part of the bonding rings

(Ref. MUNPAC100) and on the basal surface of the framework.

Place a bonding ring into each slot of the framework.

Reposition and screw the entire assembly onto the master model using short or long conical abutment pick-up screws (Ref MUT101 or MUT102).

Let dry in accordance with drying time instructions provided

by the manufacturer of the adhesive.

In the mouth

• PLACEMENT OF THE PROSTHESIS:

Screw the entire ‘frame+prosthesis’ assembly into the

mouth using new M1.4 Multi-Unit Black Tite® screws dedicated

with the bonding rings.

Tighten to 15 N.cm using the dynamometric ratchet

wrench and hexagonal wrench or TORQ CONTROL®.

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A B

L C. CEMENTED MULTIPLE-UNIT PROSTHESIS

Perform restoration using aesthetic, standard, cast-on or cut abutments.

Please see the following pages:

Aesthetic abutments: p. 24 à 25

Standard abutments: p. 26 à 27

Cast-on abutments: p. 30 à 31

Reworkable abutments: p. 32 à 33

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LOCATOR® ABUTMENTS

Indications: Stabilisation of a partial implant-supported restoration, overdenture stabilisation. (Axiom® BL)

Catalogue p.82

Features: LOCATOR® abutments are supplied decontaminated and non sterile.

The recommended tightening torque is 25 N.cm for LOCATOR® abutments. LOCATOR® attachments (Clear, Pink, Blue) can correct divergence up to 20°between two implants. Extended range attachments (Red, Green, Orange, Grey) can correct

divergence up to 40° between 2 implants.

SELECTING THE LOCATOR® ABUTMENT

Choose the abutment from the 5 gingival heights (1.5, 2.5, 3.5, 4.5 and 5.5 mm) for 1 single emergence diameter (Ø

4.0mm) available. The selection of the LOCATOR® abutment will depend on the healing screw in place, and the emer-gence profile will have to be preserved. The LOCATOR® abutment can also be used during the healing stage.

A 5.5 mm high LOCATOR® abutment requires the use of a healing screw OPHS440.

EQUIPMENT REQUIRED

USER PROTOCOL Direct or indirect technique can be used with the LOCATOR® abutment.

• INDIRECT TECHNIQUE

Placement of LOCATOR® abutment

Screw the LOCATOR® abutment into the implant using the LOCATOR® wrench (torque 25 N.cm), the ratchet

wrench or TORQ CONTROL®

LOCATOR® mandrel

OPML230

LOCATOR® wrench

OPCL150

LOCATOR® transfer +

nylon (black)

OPLA500

LOCATOR® analog

OPLA600

« 3 in 1 » tool

OPCL3E1

EMERGENCE PROFILE

Ø 4.0

OPHS410 or

OPHSF410

OPHS420 or

OPHSF420

OPHS430 or

OPHSF430

OPHS440 or

OPHSF440

OPHS440

OPLA010 Gh: 1.5

OPLA020 Gh: 2.5

OPLA030 Gh: 3.5

OPLA040 Gh: 4.5

OPLA050 GH: 5.5

5. Removable prosthesis with attachments

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Clear attachment (2268g - 5Lbs)

STANDARD

RETENTION

Pink attachment (1361g - 3.0Lbs)

MEDIUM

RETENTION

Blue attachment (680g - 1.5Lbs)

LOW

RETENTION

Green attachment

(1361-1814g - 3.0-4.0Lbs)

MEDIUM

RETENTION

Orange attachment

(907g - 2.0-0Lbs)

LIGHT

RETENTION

Red attachment

(226-680g - 0.5-1.5Lbs)

EXTRA-LIGHT

RETENTION

Grey attachment

(0Lbs)

NONE

RETENTION

Impression taking and transfer

Place the LOCATOR® impression transfers on the abutments.

Take an impression. The transfers remain in the impression.

Place the analogs in the impression and cast the model.

Restoration procedure

For less than 20 degrees of divergence between 2 implants (up to 10° per implant)

For a total divergence of up to 40 degrees between 2 implants (up to 20° per implant)

Can be used during restoration procedures

« 3 in 1 » tool

Spacer ring Black housing

TEMPORARY

RETENTION

Male removal tool Male seating tool Abutment driver

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Restoration procedure (continue)

In the master cast, place the LOCATOR® reten-tion replacement males with the black processing males onto the analogs. Then, make a model of

the removable denture.

Once the model is made, remove the retention replacement males from the master model and place a spacer ring on each analog so as to make sure that the finished denture will be correctly positioned with obtaining the resilience and ade-

quate pivoting.

Once the definitive prosthesis is made, remove the spacer rings and polish the basal surface of the prosthesis. Then, replace the housing with black low density males with definitive males. Use the LOCATOR® instrument to hold the black male

and to remove it.

Use the second part of the LOCATOR® instru-ment to hold the definitive male (clear, pink or blue). If 3 attachments or more are positioned on the same arch, always start with the lowest reten-tion replacement males (pink or blue if the diver-gence is less than 20° between 2 implants. Or-ange, red or grey if the divergence is less than 40°

between 2 implants).

Try the finished denture on the master model before placing it into the patient’s mouth.

• DIRECT TECHNIQUE (DENTAL OFFICE)

THIS TECHNIQUE IS RECOMMENDED FOR THE STABILISATION OF AN EXISTING OVERDENTURE:

Place the spacer rings on the LOCATOR® abutments in the patient’s mouth (use dental dams).

Fix the LOCATOR® retention replacement males on the abutments (black seal aimed for restoration procedure).

Hollow out the existing denture base in the areas of the retention replacement males (no interference between the

denture caps and the denture).

Cover the LOCATOR® retention replacement males with resin and fill the connecting holes in the basal surface of the

denture.

Place the denture directly into the patient’s mouth and polymerize the resin.

Once the resin has hardened, remove the denture from the mouth. Remove the spacer rings before replacing the

black males with the definitive males. Place the definitive denture into the patient’s mouth.

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Prosthesis on Axiom® TL

1. Axiom® TL range of prosthetic components

For the Simeda customised prosthesis, please see the Simeda Design guide available in the library on www.anthogyr.fr

under the “Brochures” tab

(1): Multiple-Unit only

WARNING! The emergence profile must not be altered in order to maintain the surface state of the gingiva. All final components

assembled on the implant are fixed by tightening to 25 N cm, except the healing screws and closure screw (manual tight-ening

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2. Healing management

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Indication: Sealing and healing screws to close Axiom® TL implants and inLink® abutments.

Features: Sealing and healing screws are delivered Q for single use.

EQUIPMENT REQUIRED

THE SEALING SCREW

The sealing screw are available in 2 platform diameters (Ø4.0 and Ø4.8).

TSS-N0 TSS-R0

THE HEALING SCREW

THS-N200 THS-R200 THS-N210 THS-N410 THS-R210 THS-R410

Straight healing screws are available in 1 coronal height (2mm) and 2

platform diameters (Ø4.0 and Ø4.8) and conical healing screws are

available in 2 coronal heights (2mm and 4mm) and 2 platform diameters

(Ø4.0 and Ø4.8).

Ø 4.8

Ht: 4mm Ø 4.8

Ht: 2mm

Ø 4.0

Ht: 2mm

Manual surgical wrench

OPCS100

Design conique Ø 4.0

Ht: 4mm Ø 4.0

Ht: 2mm

Ø 4.8

Ht: 2mm

Ø 4.0 Ø 4.8

HEALING SCREW (DIA./

REFERENCE HEIGHT)

Ht. 2 Ht. 4

Straight Conical

Ø 4.0

Ø 4.8

Design droit

Suture around the neck of the

implant Put the screw in place with


55


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• POSITIONING THE HEALING SCREW AND SUTURING

Do not use rotating power tools to screw/unscrew prosthetic components.

Suture around the healing

screw

Put the screw in place with the

manual surgical wrench. (Moderate

manual tightening

56

INDEXED POP-IN TRANSFER COPING

Indications: Impression taking with closed tray Pop-in technique for single-unit restoration on Axiom® TL implant


Single use

CHOICE OF THE TRANSFER

Pop-in transfer coping are available in 2 platform diameters (N: Ø4.0 and R: Ø4.8).

EQUIPMENT REQUIRED

USER PROTOCOL

• IN THE DENTAL PRACTICE: Remove the filling or healing screw or the temporary

restoration with a hexagonal wrench.

Place the Pop-in coping on the implant and tighten the Pop-in transfer coping screw (moderate manual

tightening

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B/ INDEXED TEMPORARY PROSTHESIS

n

INDEXED TEMPORARY ABUTMENT

Indications: Single-unit or multiple-unit temporary restoration on Axiom® TL implant

TC100-N TC100-R

Features: Delivered non sterile Supplied with a M1.6 Axiom® TL titanium screw

Tighten at 25 N.cm

CHOICE OF THE ABUTMENT

The temporary abutments are available in 2 platform diameters (N: Ø4.0 and R: Ø4.8).

EQUIPMENT REQUIRED

CREATION AND PLACEMENT OF TEMPORARY PROSTHESIS

• IN THE LABORATORY: Screw the temporary abutment on the master model with a hexagonal wrench. Moderate manual tightening (

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n

EQUIPMENT REQUIRED

PROTOCOL

Digitalise platform with the Scan Adapter with a Simeda approved laboratory scanner.

(See Simeda Design guide Ref C175 available in the Library of the Anthogyr website)

Design the abutment with CAD software or with a wax-up created on a temporary abutment

Send the file or wax-up to Simeda for machining.

EQUIPMENT REQUIRED

USER PROTOCOL

• IN THE LABORATORY:

Delivery of the Simeda customised abutment

Prepare the restoration with a M1.6 Axiom® TL long or short laboratory screw (Ref. TS162 / TS163)

During the polishing stages, protect the platform with an analogue.

• IN THE DENTAL PRACTICE:

Place the prosthesis in the mouth.

Tighten the screw supplied with the temporary abutment (Ref. TS161) to 25 N.cm with a prosthetic torque wrench (

Ref. INCCD) and a hexagonal wrench or TORQ CONTROL® wrench and a hexagonal mandrel

Fill the screw channel, then close again with composite.

C/ INDEXED PERMANENT SINGLE-UNIT RESTORATION

Tightening tool Scan-Adapter SATOOL-01

Laboratory Scan-Adapter

402156-0X-SAA

a/LABORATORY PROSTHESIS DESIGN

b/ CREATION AND PLACEMENT OF THE PROSTHESIS

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Hexagonal wrenches


Hexagonal mandrels

INMHECV-INMHELV- INMHEXLV

Implant analog

TA100-N / TA100-R

M1.6 Axiom® TL

laboratory screw long

TS162

M1.6 Axiom® TL

laboratory screw short

TS163

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4. InLink® multiple-unit prosthesis

A/ IMPRESSION

PICK-UP TRANSFER

Indications: Open tray impression with Pick-up technique for multiple-unit restoration on Axiom® TL implants or inLink® abutments.

ILT100N ILT100R


Single use


Pick-up transfer coping are available in 2 platform diameters (N: Ø4.0 and R: Ø4.8).

EQUIPMENT REQUIRED

USER PROTOCOL

• IN THE DENTAL PRACTICE: Remove the filling or healing screw with a hexagonal wrench or remove the temporary restoration with a ball wrench. Place a Pick-up transfer coping on each inLink® con-nection and screw the short or long transfer coping screws (moderate manual tightening

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INLINK® TEMPORARY ABUTMENTS

Indications: Multiple-unit temporary restoration on inLink® connection

Catalogue p.85

Features: Delivered non sterile Supplied with the standard clinical lock and the ring Single use

Tighten at 25 N.cm


Choose temporary abutments between the 2 angulations (0° and 25°) and the 2 platform diameters (N: Ø 4.0 and R: Ø

4.8) available

EQUIPMENT REQUIRED

USER PROTOCOL

• IN THE LABORATORY: Place laboratory locks on the analogues of the master

model and screw in lightly. (details on p. 69)

Screw the temporary abutment on these laboratory locks with a ball wrench. Ensure good contact between

the platforms. Moderate manual tightening (

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n

Clear the screw channels. Unscrew and disassemble the temporary prosthesis. Place protection caps on the inLink® prosthesis con-nections before polishing. (details on p. 70) Polish the temporary prosthesis. Remove the protection caps from the temporary

prosthesis.

WARNING! Clean the connections and screw channels of the temporary prosthesis with a toothbrush, followed by

water steam.

Once the placement of the temporary prosthesis is complete, place the new clinical locks in the prosthesis with a 2-in-1 inLink® wrench. The use of clinical guide locks in the frame to facilitate placement in the mouth is recommended. They will be placed on implants with a

narrow relative divergence.

It is recommended that 2 clinical guide locks are used in frames on more than 2 implants, and 1 single clinical

guide lock is used in a frame on 2 implants.

• IN THE DENTAL PRACTICE:

Unscrew the filling or healing screw with a hexagonal wrench.

Place the temporary prosthesis with its new clinical locks in the mouth.

To facilitate the placement of the prosthesis, screw the locks progressively starting with the guide locks.

Tighten to 25 N.cm with a prosthetic torque wrench (Ref. INCCD) and a ball wrench or TORQ CONTROL® wrench and

a ball mandrel.

Perform a follow-up X-ray to check proper placement of the prosthesis.

Fill the screw channels using teflon, then close again with composite.

OPTIONAL

Temporary abutments with fitting locks (green) are available in the cata-

logue. They allow the creation of a temporary prosthesis in the mouth.

These fitting locks (green) will have to be replaced with new clinical locks (included in the package) before the prosthesis is placed in the mouth per-

manently.

Screw-retained protection caps are available to protect the platforms.

Fitting locks (STD or guide) are available for all laboratory handling requir-

ing screwing the prosthesis on the model.

WARNING ! The temporary abutments must never be used to take an impression.

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ILPCSN / ILPCSR

Catalogue p.85

ILL100T-4 / ILLG100T-4

62

C/ INLINK® PERMANENT PROSTHESIS

The prosthesis must be designed after taking the impression validated by a plaster key

EQUIPMENT REQUIRED

PROTOCOL

Digitalise platform with the Scan Adapter with a Simeda approved laboratory scanner.

(See Simeda Design guide Ref C175 available in the Library of the Anthogyr website)

This Scan-Adapter is used like the other Scan-Adapter Simeda (see Simeda Design guide Ref C175, available in the Library

of the Anthogyr website) with the peculiarity of being steerable.

The laser marking on the top of the Scan-Adapter determines the position in the prosthesis

of the future machined groove.

To reduce to a minimum the volume of the prosthesis in the vestibular and lingual area,

place the Scan-Adapter laser markings in the prosthetic groove.

Design the frame with CAD software or with a wax-up created on temporary abutments.

Send the file or the wax-up to Simeda for machining.

EQUIPMENT REQUIRED

The clinical locks are supplied with the Simeda prosthesis

a/ LABORATORY PROSTHESIS DESIGN

b/ CREATION AND PLACEMENT OF THE PROSTHESIS

Machined groove housing the lock ring

Tightening tool Scan-Adapter SATOOL-01

Laboratory Scan-Adapter 402156-0X-SAO

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inLink® 2-in-1 wrench

IL-TOOL2

Ball wrenches

INBW100S-INBW100L

Ball mandrels

INBM100S-INBM100L

Clip protection

caps

ILPCCN-ILPCCR

Hexagonal

wrench

INCHELV

Laboratory

lock

ILL300

Standard clinical

lock

ILL100

Clinical guide

lock

ILLG100

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PROTOCOL

• IN THE LABORATORY:

Delivery of machined frame

Place clip protection caps on the inLink® connections of the

machined frame before adjusting or sanding the frame.

Fill the screw channels with wax.

Sand the frame.

Clear the screw channels.

Clean the frame with water steam.

Remove the protection caps.

Place the laboratory locks on the master model by screwing

lightly and ensuring good contact between platforms.

The placement of 2 to 4 locks according to the length of the prosthesis is recommended. Place these locks on the ana-

logues with the least relative divergence.

Prepare the frame as follows

Resin prosthesis - Fill the screw channels with wax. - Pour the resin prosthesis. - Perforate the temporary prosthesis to access the screw channels. - Clear the screw channels. Unscrew and remove the pros-thesis from the master model.

Ceramic prosthesis - Assemble the ceramic restoration on the frame. - Slightly unscrew the laboratory locks to release the frame between each firing stage. - Sand lightly inside the connections to remove the oxidation layer (sanding with aluminium oxide 50 µm, up to 2 bars)

Before polishing the frame, protect the connections with protection caps. Polish the prosthesis. Remove the protection caps.

WARNING ! Clean the connections and screw channels of the prosthesis

with a toothbrush, followed by water steam.

Once the placement of the prosthesis is complete, place the new clinical locks in the prosthesis with a 2-in-1 inLink®

wrench for final delivery to the practitioner.

To facilitate placement, it is recommended that 2 clinical guide locks are used in frames on more than 2 implants, and 1 single clinical guide lock is used in a frame on 2 implants. They will be

placed on implants with a narrow relative divergence.

WARNING ! The laboratory locks, fitting locks and clinical locks must not be fired.

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• IN THE DENTAL PRACTICE: Unscrew the healing screw with a hexagonal wrench or the

temporary prosthesis with a ball wrench.

Place the prosthesis with its new clinical locks in the mouth.

To facilitate the placement of the prosthesis, screw the locks

progressively starting with the guide locks.

Tighten to 25 N.cm with a prosthetic torque wrench (Ref. INCCD) and a ball wrench or TORQ CONTROL® wrench

and a ball mandrel.

Perform a follow-up X-ray to check proper placement of the

prosthesis.

Fill the screw channels using teflon, then close again with

composite.

PROSTHESIS MAINTENANCE:

Replacement of the locks with new locks is recommended each time the prosthesis is disassembled. Clinical locks on grippers are available to facilitate placement.

OPTIONAL

Fitting locks (STD or guide) are available for use with intraoral prosthetic fittings, occlu-sion adjustments or for all laboratory handling requiring screwing the prosthesis on the

model.

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