The Implant Ninja Guide to:

First, place the comfort caps (aka healing

abutments) on the multi-unit abutments
and suture up the flap.
Careful not to suture too tightly around
the platforms or else you’ll have a hell of
a time trying to seat the prosthesis later!

Place blue mousse inside the intaglio of

the denture, seat it on the ridge, and have
the patient bite down into occlusion. This
will provide an index of the implant
positions in the bite reg material.
Then, use a football acrylic bur and just
make a hole right through the denture in
each of those locations. But make sure not
to dislodge the Blue Mousse!

Take off those comfort caps and place

multi-unit temporary titanium abutments
on each implant.

Check that there’s at least 2mm clearance

around each cylinder. Clearance will
provide access to inject an acrylic pick-up
material and ensures that the cylinders will
not prevent the denture from seating
properly.
You can see that some of the titanium
cylinders are binding so the denture still has
to be adjusted. Check to see if any of the
cylinders protrude through the denture and
may interfere with occlusion.

Punch some holes into a rubber dam and

slip that over the cylinders. The purpose
of the rubber dam is so that:
1. Acrylic doesn’t seep into the wound
2. The acrylic does not harden around
the sutures and rip them out when I
remove the denture.

Place Teflon tape inside of the

access holes to make sure that I
don’t get any acrylic inside the
cylinders and block the access
holes.

Here I even made some buccal holes

around the cylinders inject acrylic into.
This can help prevent voids.
Then, mix the acrylic in large silicone
mixing cup, quickly pour it into a
Monoject syringe, suction and dry
around the cylinders, and squirt it
around the titanium cylinders then
seat the denture into the proper
position.

Add some acrylic through the buccal

holes too!
Make sure the patient bites down into
occlusion as soon as you are done
injecting acrylic. This will make sure
vertical dimension and occlusion are
correct. Check and recheck the midline
before the acrylic hardens.

After the material is set, remove the teflon

from the cylinders and unscrew each
abutment.
Gently clean around the cylinders and fill
the voids around the titanium cylinders in
the intaglio surface with more acrylic.
Use a salt-and-pepper technique to apply
acrylic around the cylinders. Do not to fill
in too much material in the intaglio surface
because this will make it more difficult to
seat your prosthesis!

Once the voids are filled, cut off the flange, cut off the tooth distal to the last
implant, and trim polish the denture. The picture here shows a rather wide
prosthesis. It’s probably wider than ideal. You have to balance cleansibility with
strength at this point.

Torque down to 15Ncm when multi-unit abutments are used and to 35Ncm
when going directly to the fixture level. I adjust occlusion (no occlusion distal to
the last implant!) and then fill the access holes with light body PVS. I usually
bring the patient back for a next day follow up during which I recheck
occlusion.

CHECKLIST
Multi-Unit Abutments (3-4mm Conversion Materials:
height works okay):  Acrylic Bar
Regular platform  Bite Registration Material
 30 degree: Quantity 2  Teflon Tape
 15 degree: Quantity 4  Grinding Stone Bur for
 Straight: Quantity 2 Straight Handpiece
Narrow Platform  Pink Acrylic
 30 degree: Quantity 2  Unifast Trad works great
 15 degree: Quantity 4 for really fast set
 Straight: Quantity 2  Zest Anchors Chairside re-
line gun also works
 White acrylic (any works
Prosthetic Implant Components: fine)
 Multi-unit analogs: Quantity  Denture polishing burs
6
 Pumice and Lathe
 Multi unit Titanium tempo-
rary copings: Quantity 6  Articulating Paper
 Multi-unit healing abutments:
Quantity 6

209-933-1817
implantninja@gmail.com

www.implantninjaedu.com