Step by Step

Step Bicon by Restorative Step

Manual
Simple. Predictable. Profitable.
Page
TM
Dear Colleagues:
The procedures and techniques depicted in the following pages have been
successfully utilized over the years by many Bicon clinicians. However, as
any experienced dentist knows, there are many ways of achieving a
particular result and by no means are the depicted techniques the only way
of providing for your patients’ needs.
Clinicians for whom the Bicon system is a new experience should be
impressed with the flexibility, forgivingness, and facility with which Bicon
implants can be placed and restored, as well as how easily and
consistently gingival aesthetics can be achieved.
Many of Bicon’s beneficial restorative attributes, such as the extra- oral
cementation of crowns and the Bicon Integrated Abutment CrownTM, are
directly related to the implant’s elegant design with a demonstrated
bacterially-sealed, 1.5 ̊ locking taper connection, which provides for 360 ̊ of
universal abutment positioning.
Hopefully, with only a few of the depicted techniques, you and your patients
will enjoy the benefits of the Bicon system — such as never again having to
apologize to your patients for a dark metallic gum line.
Sincerely,
Vincent J. Morgan, D.M.D.
Bicon 501 Arborway Boston, MA 02130 tel: (800) 88-BICON or (617) 524-4443 www.bicon.com
Step by Step
Table of Contents
Crown and Bridge
............................................................................................
1
Flowchart
...............................................................................

2-3
Porcelain Fused to Metal
..................................................................................
5-13
Temporization with Emergence Cuff
..........................................................
6
Non-Shouldered Abutment Measurement Guide
................................................
6 Direct
Abutment Level Impression
............................................................
7
Temporary or Healing Abutments
............................................................
8
Implant Level Impression
...................................................................
8
Extra-Oral Cementation
....................................................................
8
Non-Shouldered Abutment Prosthetic Components
..............................................
9
Temporization with an Acrylic Sleeve
..........................................................
10
Temporization and Impression of an Unmodified Abutment with an Acrylic Sleeve
.....................
11
Temporization and Impression of an Occlusally Modified Abutment with an Acrylic Sleeve
...............
12
Cementation
.............................................................................
12
Laboratory Technique: Crown Fabrication with an Acrylic Sleeve
....................................

13
All-Ceramic Crown
...........................................................................................
15-22
Abutment Selection
.......................................................................
16
Stealth Shouldered Abutment Measurement Guide
..............................................
16
Acrylic Sleeve Selection
....................................................................
17
Indirect Abutment Transfer / Temporization
....................................................
17
Extra-Oral Cementation (with DiamondLinkTM)
...................................................
18
Intra-Oral Cementation (with DiamondLinkTM)
...................................................
19
Laboratory Technique: Implant Level Impression
.................................................
 20
Laboratory Technique: Abutment Level Transfer Impression and Aluminum Oxide Sleeve
................

21-
22 Bicon Integrated Abutment CrownTM (IAC)
...........................................................
23-36
Impression Technique
......................................................................
24
Temporization Technique
...................................................................
25
Seating of an Integrated Abutment Crown (IAC)
.................................................
26
Seating Considerations
.....................................................................
27
Additions to Existing IAC
....................................................................
28
Laboratory Technique
......................................................................
29-35
Abutment Selection
.......................................................................

36
Overdenture Restorations
................................................................................
37-47
BrevisTM Abutment
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
38-41
Chairside Technique
.......................................................................
38-39
Indirect Transfer Impression
.................................................................
40
Rubber O-Ring Maintenance
................................................................
41
BrevisTM Abutment Measurement Guide
........................................................
41
Fixed-Detachable Abutment
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. .
42-43
Indirect Transfer Impression
.................................................................
42-43
Fixed-Detachable Abutment Measurement Guide
...............................................
43
Telescopic Restoration
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . .

44-
47 Techniques
..............................................................................................
.......
49-63
Immediate Stabilization and Function
.........................................................
50-51
Implant Level Impression
...................................................................
52
Occlusal Registration
.......................................................................
52
Impression Reamer
........................................................................
53
Seating of Abutments
......................................................................
54-55
Seating of IACs or Extra-Orally Cemented Restorations
............................................
56-58
Laboratory Maxillary Anterior Seating Jig Fabrication
.............................................
59
Maxillary Anterior Seating Checklist
...........................................................
60-61
Occlusal Considerations
....................................................................
62
Recommended Restorative Products
..........................................................
62
Removal of Abutments or Crowns
............................................................
63
Copyright © 2005 Bicon R1105
Step by Step
Crown and Bridge
Page
Step Single Crown and by Bridge Restorations:
Step
Flowchart
PFM
Non-Shouldered butment
Method of
Indirect
Impression
Implant Level

Impression Product Needed

Implant Level Impression Kit

Temporization Product Needed

Direct butment Level
Emergence Cuff or Temporization Sleeve for Non-Shouldered butment
Temporary or Healing butment and/or Transitional Crown

Laboratory Product Needed

Final Crown
Page
Single Crown and Bridge Restorations: Flowchart
Indirect butment Level
Impression Sleeve None
for Non-Shouldered butment
Temporization Sleeve for Non-Shouldered butment
butment Transfer Die
None
and crylic Sleeve
Non-Shouldered for Non-Shouldered
butment butment
• For extra-oral cementation follow the indirect implant level technique . • Each implant
level
Step Single Crown and Bridge by Restorations:
Step
Flowchart
ll-Ceramic
Integrated butment Crown
Stealth Shouldered butment
Non-Shouldered butment or Shouldered butment
Indirect butment Level
Single Crown and Bridge Restorations: Flowchart
Page Indirect Implant
Level
Indirect Implant Level
crylic Sleeve for Shouldered butment
Implant Level Impression Kit
crylic Sleeve for Shouldered butment
e . • Each implant level impression kit contains one impression post and one implant
analog .
Implant Level Impression Kit
Temporary or Healing butment and/or Transitional Crown
Temporary or Healing butment and/or Transitional Crown
luminum Oxide
luminum Oxide
Non-Shouldered Sleeve &
Sleeve &
butment or butment
Stealth Shouldered
Shouldered Transfer Die
butment
butment
Final Crown Final Crown
Step by Step
Page
Step by Step
Porcelain Fused to Metal
Page
Step Porcelain Fused by to Metal:
Non-Shouldered Step
butment
Temporization with Emergence Cuff
Choose the widest abutment that supports
but does not encroach upon the interdental papillae and whose height can satisfy all occlusal considerations. Seat
the abutment with its corresponding emergence cuff into the implant well. butment diameter dictates the diameter of
the emergence cuff.
Incorporate the emergence cuff into the
transitional crown such that it becomes the apical third of the transitional crown. The circumferential groove on the
emergence cuff allows the transitional crown material to mechanically lock to the emergence cuff. The emergence
cuff may be easily modified to achieve a desired sulcus contour. Trim and polish the transitional crown prior to
cementing it to the abutment with temporary cement. Allow the soft tissue to mature for at least 6
weeks after a stage two surgical uncovering prior to making an impression.
Remove the transitional crown with the emergence cuff before making the final impression.
Make a direct impression of the modified or unmodified abutment and pour a conventional stone model. The
laboratory procedures are the same as for the fabrication of a crown or fixed bridge for a natural tooth.
After any needed occlusal, interproximal,
or aesthetic contouring, cement the crown conventionally with minimal cement at the cervical aspect of the crown to
avoid adverse hydraulic forces. Care must be taken to remove all extraneous cement.

Measurement Guide
The design of the Bicon abutment system is such that the hemispherical base of the abutment does not sit flush with
the neck of the implant . By design, there is a space below the abutment post when the abutment is fully seated .
When viewing this on a radiograph, it can be seen as a radiolucency . Please note that the post of any abutment may
not be modified. Altering the abutment post in any manner or using a cementing medium will affect the frictional fit of
the locking taper resulting in a potentially non-retentive abutment. The following diagrams depict the final seating of
the 2 .0mm and 3 .0mm non-shouldered abutments as well as the method for measuring each abutment .
Page
Porcelain Fused to Metal: Non-Shouldered Abutment — Temporization with Emergence Cuff
The width of the abutment is measured at the widest part of the abutment . The height of the non-shouldered
abutment is measured from the widest portion to the occlusal aspect of the abutment . The abutment post height is
constant and is not variable.

Mature tissue

Make impression
4 .0mm

Choose emergence cuff

Non-Shouldered butment with .0mm Post
Non-Shouldered butment with .0mm Post
Width Width t h g i e H
t h g i e H Abutment Post Height
Abutment Post Height
5 .0mm
6 .5mm
The width of the abutment is measured at the widest part of the abutment . The height of the non-shouldered
abutment is measured from the widest portion to the occlusal aspect of the abutment . The abutment post height is
constant and is not variable.

Transitional crown

Healed sulcus

Cement crown
Step Porcelain Fused to Metal: Non-Shouldered
by Step
butment
Direct butment Level Impression
At the time of implant uncovering, place a
non-shouldered abutment and allow the soft tissue to heal around the hemispherical base of the abutment
for 6 weeks. Choose the widest non-shouldered abutment that will support the interdental papillae without
encroaching upon them.
Use a sharp #1557 carbide bur to modify the
abutment, if necessary. Use irrigation when preparing the abutments intra-orally to prevent heating and
potential damage to the bone.
Make a direct impression of the modified
or unmodified abutment with conventional impression materials and pour a conventional stone model. The
laboratory procedures are the same as for the fabrication of crowns or fixed bridges for natural teeth. Use a
knife or feathered edge margin.
A try-in of the casting prior to the porcelain application is advised to assure a passive seating.
After any needed occlusal, interproximal,
or aesthetic contouring, cement the crown conventionally with minimal cement only at the cervical aspect of the
crown to avoid adverse hydraulic forces. Care must be taken to remove all extraneous cement.
Recheck the occlusion after cementation.
Note: Use irrigation when preparing the abutment intra-orally to prevent heating and potential damage to the bone .
A try-in of the casting prior to the porcelain application is advised to assure a passive seating .
A knife or feathered-edge margin is employed at the most apical portion of the die . The margin need not be at the
abutment’s height of contour .
Statistically, a 2 .0mm diameter abutment post will move 0 .1mm into the well of an implant from its initial insertion to
its being definitively seated, and a 3 .0mm abutment will move 0 .25mm .
Porcelain Fused to Metal: Non-Shouldered Abutment — Direct Abutment Level Impression
Page

Recheck occlusion
Keys to Success
• Choose the widest abutment to accommodate the edentulous space without
encroaching upon the interdental papillae.
• .mm abutments are recommended only for mandibular incisors; .0mm abutments are
primarily used for maxillary laterals and bicuspids; .0mm abutments are more universal
in their use; .mm and .mm abutments are ideally suited for molars.
• The abutment can rotate 0 ̊ to reach a desired position or to achieve parallelism prior to
seating.
• void direct handling of an abutment post, since a change of its geometry may result in a
non-retentive abutment.
• Use an abutment preparation holder (0-0-90) when modifying abutments extra-orally.
• Use irrigation when preparing an abutment intra-orally.
• Do not make an impression with the emergence cuff.
• The use of retraction cord is not necessary.
• n emergence cuff can act as a means of gingival retraction.
• The casting may end with a knife or feathered edge margin anywhere along the coronal
aspect of the abutment.
• Use minimal amount of cement at the cervical margin to avoid hydraulic forces which
may prevent the crown from seating fully.

Make impression

Place abutment

Cement crown

Try-in casting
Modify abutment (optional)