4.        Step-by-Step“Screw-Retained”     Step-by-Step     Bridge Cemented Bridge Using Using Abutments       “Multi-Unit...
© MIS Corporation. All rights Reserved.Published by MIS, which reserves the right to ameliorate theproducts described in t...
MIS is proud to present the                             “Multi-Unit” manual for a                             screw retain...
Screw retained Dolder Bar for multiple implants  The MIS “Multi-Unit” System is to be used with Biocom or Seven  implants ...
Restorative components table        Indications for Using MIS Restorative Components        * For purposes of recommendati...
MIS “Multi-Unit” SystemMIS “Multi-unit” standard and wide abutments.                                MIS angulated “Multi-U...
MA-ANH17         MA-ANH30   MA-S2375              MA-W2500
A.                                       B.Step 1.                       Implant exposure.                        Selectio...
Step 1C.Insertion ofimpression copings.Sequential view of impression coping use.The impression copings MT-IT450 areplaced ...
A.                                              B.Step 2.                   Impression procedure.                         ...
C.                                            D.Assembly of “Multi-Unit”                      Insertion of the joinedimpre...
A.                                         B.Step 3.                    Fabrication of the                           maste...
Step 3
A.                                          B.Step 4.                                Metal framework fabrication.         ...
C.Casting of framework.                                                     Step 4The cast framework is tried in. The fram...
A.                                            B.Step 5.                           Denture fabrication.                    ...
C.Denture processing.Processed (finished) denture try-in.Process the denture in the conventionalmanner. The finished dentu...
A.                                                B.Step 6.                           Rider installation.                 ...
Step 6
A.                                                   B.Step 7.                               Final insertion.             ...
Step 7
Restorative procedure      Standard Platform                                                                  Prosthetic o...
Restorative procedure      Wide Platform                                                             Prosthetic option    ...
FIN. END. FINAL. FINE. SON.   . .
All rights reserved. No part of this publication may be reproduced, transcribed, stored in anelectronic retrieval system, ...
MC-PMU04 Rev. 1                       www.mis-implants.com                 0483                         ISO 9001:2000     ...
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  1. 1. 4. Step-by-Step“Screw-Retained” Step-by-Step Bridge Cemented Bridge Using Using Abutments “Multi-Unit” Abutment Internal Hex. Implant System Internal Hex. Implant System
  2. 2. © MIS Corporation. All rights Reserved.Published by MIS, which reserves the right to ameliorate theproducts described in this manual as well as to revise thispublication at any time and without informing any personof such revision or change. All rights reserved. No part ofthis publication may be reproduced, transcribed, stored inan electronic retrieval system translated to any language orcomputer language, or be transmitted in any form whatsoeverwithout the written consent of the publisher.Note: This guide is for educational use only.
  3. 3. MIS is proud to present the “Multi-Unit” manual for a screw retained Dolder Bar formultiple implants. This manual explains, “step-by- step”, theprocedure for using MIS components. MIS scientists andengineers are committed to researching and developingnew products and technologies. Our commitment extendsto delivering procedural and product information throughtraining and instruction. For prompt attention to your questions, comments, and requests, contact MIS specialists directly at our e-mail address: service@mis-implants.com.The MIS web site is located at www.mis-implants.com.This online site highlights current products and reflects all new discoveries and developments.
  4. 4. Screw retained Dolder Bar for multiple implants The MIS “Multi-Unit” System is to be used with Biocom or Seven implants of standard or wide platforms. Using a screw retained Dolder Bar for multiple implants is a staged process. This manual illustrates the construction of a “cast-metal” framework (Dolder Bar) for multiple implants to retain a removable full denture with titanium riders, using the closed-tray impression technique. This manual is concisely written with clear “full-color” illustrations for each step. Component areas appear next to each step for clear and easy reference. Advantages Implants of standard and wide platforms can be used. ▪ Angulated abutments can be used. ▪ Suitable for limited interocclusal dimensions. ▪ Outstanding aesthetic phonetics and function. ▪ Economical, simple procedures. General Information1. Initial planning is of utmost importance. The dentist performing the prosthetic stage of the treatment should be an active participant, together with the surgeon, regarding implant choice, type of prosthesis, and the “three dimensional” positioning of the implant. It is a “prosthetic driven procedure.2. Dolder construction must be done with a parallelometer.3. Relining of dentures is more complex.4. The patient must be informed of proper denture use and hygiene.
  5. 5. Restorative components table Indications for Using MIS Restorative Components * For purposes of recommendation Standard Wide 17 degree 30 degreePlatform diameters 3.30, 3.75 and 4.20 5mm and 6mm Standard Standard implants implants 3.30, 3.75 and 3.30, 3.75 and 4.20mm implants 4.20mm implants Gingival heights From 1mm to 4mm From 1mm to 4mm Buccal 1.3mm Buccal 1.0mm gingival heights Lingual 2.5mm Lingual 3.0mm Catalog numbers MA-S1375 MA-W1500 MA-ANH17 MA-ANH30 MA-S2375 MA-W2500 MA-S3375 MA-W3500 MA-S4375 MA-W4500 Abutment description
  6. 6. MIS “Multi-Unit” SystemMIS “Multi-unit” standard and wide abutments. MIS angulated “Multi-Unit” abutments.The MIS “multi-unit” System is used to fabricate a wide range of The unique MIS angulated “multi-unit” abutments are a culminationscrew retained “implant supported” prosthetic appliances. The of exhaustive and comprehensive research. The Angulated “multi-standardized components and procedures of the “multi-unit” system Unit” System has a patent pending and can be found only at MIS.make it simple and reliable to use. The angulated “multi-unit” is supplied in 170 or 300 angulations and is for use with standard platform Biocom and Seven implants.The standard “multi-unit” abutments are to be used with the standard The abutments are composed of Grade 5 titanium for maximumplatform internal hexagonal connection of Biocom and Seven implants, biocompatibility and strength.while the wide “multi-unit” abutments are to be used with both 5mm and6mm Biocom and Seven implants. The low profile of the abutments The angulated “multi-unit” abutments allow greater distancing betweenenables them to be placed in areas of limited occlusal space and implants, providing a wider base for stabler prosthetic appliances.where the path of insertion is difficult. Simple and accurate impression Anatomic obstacles can be avoided, reducing risk and eliminatingprocedures coupled with precision laboratory components ensure a the need for additional surgical interventions. The angulated “multi-reliable and predictable prosthetic outcome. The “multi-unit” system unit” abutment design enables an abutment to be rotated throughis the benchmark for screw retained prosthetic appliances. six different positions and then locked in its chosen position. The versatility of the angulated “multi-unit” abutments can be used to solve challenging instances where paths of insertion and vertical dimensions are difficult. 15° 15° 15° 1.2mm 15° 1mm-4mm 1mm-4mm 1.2mm 3.2mm 2.6mm 1.3mm 1mmMA-S2375 MA-W2500 MA-ANH17 MA-ANH30
  7. 7. MA-ANH17 MA-ANH30 MA-S2375 MA-W2500
  8. 8. A. B.Step 1. Implant exposure. Selection of “Multi-Unit” abutments.Components: Implants MF7-11375 Healing caps MH-00450 “Multi-unit” abutments MA-S1375 Removal of healing caps. Insertion of “multi-unit” abutments. Guide pins MM-GP450 Impression copings The “multi-unit “healing caps MH-00450 The “multi-unit” abutments MA-S1375-MA- MT-IT450 are made of titanium and have a 3mm S4375 or Wide MA-WS1500-MA-W4500 length. The “multi-unit” healing caps are selected according to gingival height may be removed approximately three at each implant site. They are inserted with Impression key MT-IT100 weeks after exposure. the “multi-unit” screwdriver MT-MUK02. Screwdriver MT-HHR13
  9. 9. Step 1C.Insertion ofimpression copings.Sequential view of impression coping use.The impression copings MT-IT450 areplaced on the “multi-unit” abutments, andguide pins MM-GP450 are inserted andtightened into place using the “closed-tray” impression key MT-IT100.
  10. 10. A. B.Step 2. Impression procedure. Inverted “closed-tray” impression.Components: Implants MF7-11375 Impression key MT-IT100 Guide pins MM-GP450 Impression tray completely filled and seated. Impression copings MT-IT450 Impression tray completely filled and seated. Once the impression material has completely set, the impression tray is Abutment analogs MA-RSM10 removed and checked for accuracy. The impression copings should be removed from the patient’s mouth, using the “closed-tray” impression coping In order to achieve optimal results, a key MT-IT100. properly fitting standard impression tray should be selected. The impression copings should be fully covered with impression material, and the impression tray should be completely filled.
  11. 11. C. D.Assembly of “Multi-Unit” Insertion of the joinedimpression coping and Step 2 components into theabutment analog. impression.Connection of impression coping to analog. Accurate placement of the joined components back into the impression.Place the impression coping MM-IT450 Insertion of the joined impression copingonto the “multi-unit” abutment analog MM-IT450 and “multi unit “abutmentMA-RSM10; then insert the guide pin analog MA-RSM10 back into theMM-GP450. Fasten the parts together, impression. Check that the joined partsusing the “closed-tray” impression coping are seated accurately.key MT-IT100.
  12. 12. A. B.Step 3. Fabrication of the master model. Metal framework fabrication.Components: Abutment analogs MA-RSM10 Guide pins MM-GP450 Impression copings Exposed “multi-unit” Impression copings. Direct plastic cylinders screwed onto the MT-IT450 “multi-unit “abutment analogs. Impression key MT-IT100 Cast impression according to accepted The impression coping MM-IT450 is removed, conventional methods. Once the dental using the “closed-tray” impression coping “Multi-unit” direct stone has completely set, the impression key MT-IT100 to expose the “multi-unit” plastic cylinders tray is removed. abutment analog MA-RSM10. MM-CP450
  13. 13. Step 3
  14. 14. A. B.Step 4. Metal framework fabrication. Fabrication of the master model.Components: Multi-unit abutments MA-S1375 Abutment analogs MA-RSM10 Hand hex. driver MT-HHR13 Waxed framework. A distance of 2mm is required “Multi-unit” direct prosthetic between the Dolder bar and the crest of the ridge. titanium screws MM-S0330 “Multi-unit” direct Direct plastic cylinders screwed onto the plastic cylinders “multi-unit” abutment analogs. MM-CP450 Plastic bar The “multi-unit” direct plastic cylinders MM-PBU10 MM-CP045 are selected and are screwed into place on the “multi-unit “abutment Sprued framework. Technical hex. analogs MA-RSM10 with the screw screwdriver MM-S0330, using the technical hex. MT-HTS10 screwdrivers MT-HTS10. Connection of the plastic bar MM-PBU10 to the direct plastic cylinders is done by carefully measuring and cutting the plastic bar. A parallelometer must be used to accurately attach each segment.
  15. 15. C.Casting of framework. Step 4The cast framework is tried in. The framework mustseat passively.The waxed framework is sprued, investedand cast in the conventional manner. Thefinished and polished framework is thensent to the clinician for try-in.
  16. 16. A. B.Step 5. Denture fabrication. Denture “wax-up”.Components: Implants MF7-11375 “Multi-unit” direct prosthetic titanium screws MM-S0330 “Multi-unit” abutments MA-S1375 Screwdriver MT-HHR13 Framework blocked out prior to duplication. “Wax-up” of denture on duplicated master model. Technical hex. screwdriver MT-HTS10 The framework is screwed to the A “wax-up” of the denture is done on the master model, using the technical hex. duplicated model and sent to the clinician screwdriver MT-HTS10, and is blocked for try-in. The denture should be tried out and duplicated. in without the metal framework. This is to ensure that the denture fits properly.
  17. 17. C.Denture processing.Processed (finished) denture try-in.Process the denture in the conventionalmanner. The finished denture is tried inonce more and checked for accuracy, first Step 5without the framework to make certain thatthe denture fits properly and then againwith the framework ,to make certain thatthe framework, does not interfere with theseating of the denture.
  18. 18. A. B.Step 6. Rider installation. Rider connection.Components: Abutment analogs MA-RSM10 Denture replaced on the rider and model with “Multi-Unit” direct prosthetic titanium screws “self-curing” acrylic. MM-S0330 “Multi-unit” abutment “Blocked-out” rider on duplicated master model. analog titanium rider MM-TRU10 Excess denture acrylic is removed from the base of the denture to allow room for the Technical hex. titanium rider MM-TRU10. The rider is cut screwdriver into sections and placed on the duplicate Inverted denture showing riders properly attached MT-HTS10 master model. The rider is blocked out to denture base. to ensure the self-curing acrylic will not seep under the dolder bar. “Self-curing” acrylic is mixed to a thick consistency and carefully placed on the titanium rider and also into the denture base. The denture is then accurately replaced onto the model and cured.
  19. 19. Step 6
  20. 20. A. B.Step 7. Final insertion. Final result.Components: Implants MF7-11375 “Multi-unit” direct prosthetic titanium screws Installation of framework and denture with riders. MM-S0330 “Multi-unit’ abutments Installation of framework and denture with riders. The denture is replaced, and adjusted. MA-S1375 Screwdriver MT-HHR13 The framework, is returned and screwed The clinician adjusts the occlusion if into place. The denture with riders attached needed and instructs the patient how to is inserted over the framework and gently properly use and clean the denture. pressed into position.The recomended
  21. 21. Step 7
  22. 22. Restorative procedure Standard Platform Prosthetic options Impression Healing caps copings Analogs Standard Angulated 17° Angulated 30°Implants MA-S1375 MM-ANH17 MM-ANH30 MA-S2375 MA-S3375 MH-00450 MM-GP450 MA-RSM10 MA-S4375 MT-IT450 BiocomØ 3.30mmØ 3.75mmØ 4.20mm MM-MG450 MM-CPO45 MM-BGC45 SevenØ 3.75mmØ 4.20mm MM-TO450 MM-SO330 MM-GO330
  23. 23. Restorative procedure Wide Platform Prosthetic option Impression Healing caps copings Analogs WideImplants MA-W1500 MA-W2500 MA-W3500 MH-00450 MM-GP450 MA-RSM10 MA-W4500 MT-IT450Biocom Ø 5mm Ø 6mm MM-MG450 MM-CPO45 MM-BGC45 Seven Ø 5mm Ø 6mm MM-TO450 MM-SO330 MM-GO330
  24. 24. FIN. END. FINAL. FINE. SON. . .
  25. 25. All rights reserved. No part of this publication may be reproduced, transcribed, stored in anelectronic retrieval system, translated into any language or computer language, or be transmittedin any form whatsoever, without the prior written consent of the publisher. Warning: Only a licenseddentist should use these products.
  26. 26. MC-PMU04 Rev. 1 www.mis-implants.com 0483 ISO 9001:2000 ISO 13485:2003 Authorized European Representative: M I S I mp l a n t s Te c h n o l o g i e s G mb H P aulinenstr. 12a , 32427 Minden, GERMA NY Tel: +49 571 97 27 69 0 ; Email: service@mis-implants.de© MIS Corporation. All right Reserved

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