Prosthetics – Hybrid

The following describes the impressioning and laboratory procedures for the Myriad-Smart™ and the Myriad-Hybrid™ implants as they share the same prosthetic platform and prosthetic components are common to both the implants.

IMPRESSIONING

The components available for the Myriad-Smart™ impressions and transfers include following:

•Impression transfer cap
•Retraction cap
•Impression coping
•Laboratory analog

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Clinical situation – No abutment preparation required

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With adequate interocclusal clearance and optimal gingival margins in the posterior regions in most cases no abutment preparation is required.

In these situations the comfort cap is removed and the snap on transfer cap placed to effect the impression and transfer procedure.

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A silicone monophase or polyether impression material is syringed around the abutment and transfer cap and the impression tray loaded with the same material seated.

After the material has set the tray is removed with the transfer cap locked into the impression.

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The laboratory analog is indexed to the flat surfaces and repositioned into the transfer cap in the impression.

Soft tissue mask is syringed around the abutment neck area following which die stone is poured to produce the final working model.


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Clinical situation – abutment prep required

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In cases where the there is inadequate interocclusal clearance and margins need to be relocated, preps  must be made using rotary carbide burs only.

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Gingival retraction is accomplished using the soft retraction cap.  The retraction cap is placed on the prepped abutment and the patient bites on a cotton roll onto the cap for 60 seconds.  Impression technique here is similar to normal crown and bridge procedures.

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Die stone is directly poured into the impression to duplicate the abutment stump.  This model can be sectioned and the stump treated like a tooth stump for standard crown and bridge laboratory procedures.


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Clinical situation – abutment preparation required – transfer coping  technique

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Abutment preparation to be made using carbide burs only.

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Retraction procedures using the soft retraction cap.

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Impression material is syringed around the prepared stump as well as loaded into the impression coping.  The impression coping is seated over the prepared stump to make a very accurate dynamic pressure impression of the stump.

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Once this impression has set, an impression tray with the same material is placed over the impression coping to effect a transfer coping impression of the stump.  Model preparation techniques remain the same.


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LAB PROCEDURE

Single tooth replacement using the castable coping to fabricate a metal ceramic crown.

The burnout  castable coping to fabricate the metal coping  for the ceramic crown is placed on the abutment.

The outer surface of the coping is ribbed to accept a direct wax-up of the anatomic metal cast coping.

The completed wax-up for the cast coping in place.

Sprue spring in place for the conventional investment casting.

Finished cast precious metal coping in place.

Anatomical build-up of the ceramic before firing.

The finished metal ceramic crown in place.

The castable coping ensures a passive and accurately fitting metal ceramic crown with optimal marginal integrity.


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LAB PROCEDURE

Single tooth replacement with a Zirconia ceramic crown.

The castable coping in place.

Single molar wax-up before scanning.

The molar wax-up sprayed with scan spray ready to be scanned .

The scanned molar wax-up.

The scanned transmucosal implant area and conical stump of the Myriad-Smart™ implant.

The milled final Zirconia coping.

The  milled Zirconia base coping  on the model.

The finished Zirconia ceramic crown in place.


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