Pekkton Hybrid Appointments With Conversion

Back to Restorative Appointments

The Pekkton Hybrid Restoration is comprised of a customized CAD/CAM milled Pekkton bar, premium dental teeth, and acrylic processed with Ivocap Injection System. Pekkton has the same characteristic as human bone. Pekkton ivory lightweight framework material results in a clear reduction of mechanical stresses in the framework and the implants. It is an extremely strong material that offers shock absorbing properties not found in traditional implant restorative materials. It is the perfect restoration for rushed cases and works well for upper and lower jaws and can only be removed by the Doctor.

Advantages:

Cost
Easy Repair
Excellent weight-to-strength ratio
High Esthetics
No Metal Allergies
No Thermal or Electrical Conductivity
Quickly Produced
Superior Chewing Forces

Disadvantages:

Teeth Break (especially if the MIP plain does not coincide with CO)
Needs refurbishing every seven years or so.

Patient Requirements:

The patient needs to have good dexterity to maintain good hygiene.
Must comply to a good hygiene protocol with water pick and Allure + Tepe Hygiene Kit.

Doctor's Requirements:

15mm of restorative space from the incisal edge to the abutment platform.
Multi-Unit Abutments most likely required.

Appointments:

3 Appointments are required.

Time in Lab:

17 working days (does not include weekends, holidays, and time in transit).

Warranty:

Bar: 5 Years
Teeth and Acrylic: 1 Year
More Info

Price:

Call Lab for a price quote.
Night guard: $70 (Recommended)

RX: Hybrid Bar Sequential RX

When the patient is ready to be restored, call Allure Dental Studio and give them permission to release the case into production. Once this has been done, follow the three appointment protocols below.

Continue filling out the CAD/CAM Hybrid Bar Three-Step Sequential Prescription as provided by Allure Dental Studio. If you need a new form feel free to contact Allure Dental Studio or download the necessary page below.

Appointment 1

This is the first time that you are removing the temporary denture from the patient’s mouth since the day of surgery. You must make sure you are using the correct driver from the right manufacturer.

It will be very clear to you if the patient is using their water pick and flossing under the temporary. If they are not, the temporary will be covered in tarter and food residue. The soft tissue around the abutments will be red and swollen. This outcome is not acceptable. Maintaining the temporary and final restoration is the responsibility of the patient. Serious complications such as restoration breakage or less of implants may occur if the patient is not dedicated in taking care of their investment. We suggest that you protect yourself by having a conversation with the patient about this serious issue and document it.

Lutting the verification jig

You will receive a verification jig, seated on the model, made the day of surgery.

You will also receive a custom try. Notice the long guide pins poking through.

Notice that the jig is pre-cut.

If one piece of the jig touches another piece, remove it and adjust it with a carbide bur.

Seat the verification jig in the patient's mouth.

Lutte the jig together in the patient's mouth.

Make sure the connection is strong and will not brake.

You will receive from Allure Dental Studio a verification jig, seated on the model made the day of surgery. They are pre-cut and labeled in 4 different sections. Note that you should have a space between each piece

You will also receive a custom tray which fits perfectly over the jig. Note that the screws (guide pins) are extra-long and must poke through the tray.

Before removing anything from the patient’s mouth take a bite the patient

Remove the temporary from the patient mouth. Remove the plug, Teflon, and all screws. When you unscrew the prosthetic screws they might stay in the access hole, or just come out attached to the driver. Always check the driver before putting it in the next hole. Once the temporary is removed from the patient’s mouth, give it to your assistant to have it clean thoroughly.

Check each abutment and make sure that they are all torqued to manufacturer specification. It does happen from time to time that an abutment might be slightly lose.

Remove one piece of the jig at a time, soak in Peridex and place in the patient mouth.

If one of the jigs touches another piece, remove it and adjust with a carbide bur.

Note the placement of the jig intra-orally. The temporary abutments are non-engaging so you will have to position them as best you can, then hand torque them with your driver.

Connect all sections together with a generous amount of suitable material and extend to the left and right of the cut, above and underneath the cut. (e.g., Triad DuaLine, Dentsply; Zapit, Dental Ventures of America; GC pattern resin, GC America; any flowable resins or composites). Verify that the connections are solid, especially at the distal extremities.

Check visually for passive fit; if the interface is sub-gingival, take a radiograph to verify complete passive seating.

If a section is not seated passively, you must section, re-seat and re-lute the jig. Repeat until you get a perfect passive fit.

final impression

Prepare the custom tray with utility wax.

Heavy Body in tray.

Light Body intra-orally.

Take to patient's mouth following the same path of insertion previously practiced.

The guide pins (long screws) must poke through the wax.

Unscrew impression from patient's mouth.

To ensure a passive fit of your custom-milled bar, it is extremely important to obtain an accurate final impression.

Before preparing the tray for the impression, practice the pass of insertion into the patient mouth. Once you feel comfortable with the pass of insertion, prepare the provided custom tray with utility wax. Take a small piece and squeeze it between your fingers. Make the piece thin and apply it above each big hole. The reason for this is to control the impression material from not flowing through the holes.

Fill the tray with heavy body. Do not overflow, and do not cover the palate if you are taking an upper impression.

Apply light body in the patient mouth.

Take the impression to the patient mouth and right away make sure that the long guide pins find their way through the wax. The guide pins MUST poke through the wax. If for whatever reason the guide pins are not coming through, move the tray around to find the pins. If you can’t still find them, look for them with your finder by dinging in. You probably put too much impression material in the tray.

Unscrew each screw and remove the impression from the patient’s mouth.

duplicating the temporary

Prepare to sit temporary on model.

You may need to remove the soft tissue from the model to seat the temporary.

Mix the provided matrix.

Apply material to model, acrylic on the buccal/facial side, the facial aspect of the teeth, and the occlusion.

Carefully remove from model to avoid breakage.

Notice all major landmarks have been captured.

Don't forget to capture the model in your matrix.

Double-check fit once finished.

To save you a full restorative appointment we also require that you duplicate the temporary which will be utilized as a customized bite rim.

Take the provided model and remove the soft tissue by peeling it gently off the model.

Place the temporary appliance onto the model and hand torque 2 to 4 screws.

Mix thoroughly the matrix material that we provided to you.

Apply matrix material to the model, the acrylic on the buccal/facial side, the facial aspect of the teeth, and the occlusion.

This picture illustrates the correct application of the matrix material.

The picture illustrates an incorrect application of the material. By wrapping the matrix material all the way around the model and temporary you may have a very hard time removing the matrix due to undercuts.

The picture illustrates the left side being correct and acceptable and the right side being incorrect due to the lack of occlusal surface captured in the matrix material.

Recapitulation of all the steps.

Take a bite.

Seat the Verification jig and lute it.

Take an impression of the luted jig with provided custom tray.

Duplicate the temporary.

Once you are done with all these steps, replace the temporary in the patient’s mouth and hand torque the screws to manufacturer recommendation. Place Teflon tape or floss in access hole and cover them with light body. At this point you are done with Appointment 1.

Call Allure Dental Studio for a pick-up. Return all components, models, impressions, and our Sequential Prescription™ filled out correctly. Keep the remaining pages of the Rx in your office.

Appointment 2

frame try-in with setup

Remove screws, Teflon, and plugs from each access hole.

Ionized CAD/CAM milled bar.

Remove the temporary from the patient mouth. Remove the plug, Teflon, and all screws. When you unscrew the prosthetic screws they might stay in the access hole, or just come out attached to the driver. Always check the driver before putting it in the next hole. Once the temporary is removed from the patient’s mouth, give it to your assistant to have it clean thoroughly. Check the soft tissue and abutment for redness or swelling.

Try-in the frame and setup in the patient mouth. All our frames are anodized pink to blend better in the acrylic.

Hand-tighten each screw to manufacturer specification.

Evaluate fit, form, function

Evaluate the bite.

Verify the VDO.

Check for overall fit, form, function.

Group function is preferred with a light occlusion on the anterior.

Evaluate the VDO.

Check for fit, form, function, shade, phonetics, and midline. Make any final adjustments if needed.

Take pictures.

Once you are done with all these steps, replace the temporary in the patient’s mouth and hand torque the screws to manufacturer recommendation. Place Teflon tape or floss in access hole and cover them with light body. At this point you are done with Appointment 2.

Call Allure Dental Studio for a pick-up. Return all components, models, impressions, and our Sequential Prescription™ filled out correctly. Keep the remaining pages of the Rx in your office.

appointment 3

final delivery

For final screw placement, follow the protocol below.

Example of a successful case. Notice the passive fit achieved with a CAD/CAM milled bar.

Remove the temporary from the patient mouth. Remove the plug, Teflon, and all screws. When you unscrew the prosthetic screws they might stay in the access hole, or just come out attached to the driver. Always check the driver before putting it in the next hole. Once the temporary is removed from the patient’s mouth, give it to your assistant to have it clean thoroughly. Check the soft tissue and abutment for redness or swelling.

Place the final restoration in the patient’s mouth and check for passive and accurate fit. Make sure that you did not infringe on any soft tissue.

Start placing a screw in each hole. Do not torque the screws all the way until the last one. To unsure a successful seating of the appliance, screw the prosthetic screw all the way and then back it out 30%. By doing this, you will allow the appliance to be seated with a passive fit. Once all the screws are in, hand torque them all the way to manufacturer specifications.

Fill all access holes with Teflon tape, then acrylic or composite and finish by polishing.

Evaluate the bite, the VDO and make any final minor adjustments if needed.

Take pictures for your own portfolio.

Take a panoramic X-Ray to verify that everything seats well and passively.

Congratulation you are finished.

Make sure to provide your patient with the proper tools to maintain a healthy appliance. Allure Dental Studio partnered with TePe to create a Post-Op Care Kit to meet your patient's needs.