BioHorizons Tapered Pro Conical Instructions for use

Tapered Pro Conical
Prosthetic technique manual
table of contents
introduction modules
• Engaging abutment connection & orientation
• Disconnector tool
impression technique modules
• Open tray impression taking
• Closed tray impression taking
• Bite registration
temporary restoration modules
• Screw-retained crown using the conical temporary abutment
cement-retained restoration modules
• Cement-retained single crowns using esthetic abutments
full-arch restoration modules
• Multi-unit abutment hybrid or fixed-detachable screw-retained restoration
custom CAD/CAM restoration modules
• SmartShape™ Healers digital and closed tray impression workflows
• Digital or traditional impression taking using conical titanium scan bodies
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table of contents
How to use this manual
This prosthetic manual has many features enabled to make it easier to navigate and shop for the prosthetic components that are
needed for each technique. Below are some instructions to help you on your way to using one of the most advanced technique
manuals in implant dentistry. This manual is separated into technique modules that are updated frequently to describe the most
current protocols used in implant dentistry. For best results on a tablet device, use the iBook or Adobe Reader app.
At any time, you can jump
back to the table of contents
by clicking on the home icon
located at the top of each
page.
Click on module names
in orange text to view
additional content on the
current topic.
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Every page has a quick
link to the BioHorizons
website to browse the
latest product information
and continuing education
courses.
Each prosthetic
module can also
be printed using
Adobe Reader.
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introduction
Engaging abutment connection & orientation
BioHorizons Tapered Pro Conical and Tapered Short Conical implants are equipped with a 7.5-degree internal taper cone and
six (6) grooves in the inner configuration for positioning of the corresponding abutments.
The abutments are apical with a cone and three (3) cams and are designed to rotationally lock into the conical connection
supported by the implant’s grooves. For definitive insertion, the corresponding abutment screw is used.
cams
grooves
7.5°
taper
1
Abutment placement
Place the abutment above the implant connection and
begin insertion.
Rotate the abutment to the desired orientation and insert
so that a clear perceptible tactile feedback confirms that the
abutment is positioned correctly by three of the six grooves
of the implant and apical external taper of the abutment.
Once a perceptible tactile engagement of the abutment is
achieved, complete the insertion to final depth.
2
Abutment orientation
Abutments may be oriented in six (6) different ways at a
60-degree offset based on the position of the six (6) grooves
in the implant connection.
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introduction
Disconnector tool
BioHorizons Tapered Pro Conical and Tapered Short Conical implants are designed with a deep conical connection that
ensures a very precise, stable and rotation-resistant connection to the prosthetic components, and, therefore, an aboveaverage precision fit between the abutment and the implant.
To safely remove the abutment from the implant (adhesion force), a disconnector tool may be needed.
The disconnector tool should only be used for the removal of final abutments that engage the cone.
1
Remove the abutment screw
Remove the abutment screw or the lab screw which is
securing the abutment to the implant.
2
Engage the disconnector tool
Screw the disconnector tool into the screw channel until the
abutment releases from the internal taper of the implant or
lab implant.
If the abutment does not come loose, a torque wrench may
be placed on the disconnector (in the locked setting) and
the abutment may be loosened by turning clockwise.
Note:
The disconnector tool is not compatible with OD Secure
abutments.
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impression techniques
Open tray impression taking
The open tray, also known as the direct pick-up method, is used to make a single or multiple-unit, implant-level impression for
fabrication of a working model. In this method, the impression post is attached to the dental implant, and it is important that
the coping screw be longer than the impression post when making the impression.
Note:
The coping screw is equipped with a predetermined breaking point. If space limitations are encountered, it can be
shortened by 3.0 mm by breaking it off with the hex driver. Ensure to shorten the coping screw extra-orally only.
component options
• Conical impression post, open tray
(including coping screw)
• Conical lab analog
• .050” (1.25mm) hex driver
1
Remove the healing abutment
Remove the healing abutment using an .050” (1.25mm) hex
driver. Confirm that the implant’s prosthetic platform is free
of any bone debris or soft tissue.
Helpful Hint:
When placing impression posts on multiple implants,
remove one healing abutment at a time, replacing it
immediately with the impression post. This reduces the
likelihood of soft tissue collapse onto the implant. It is
recommended to work from posterior to anterior.
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impression techniques
Open tray impression taking
2
Place the conical impression post
Place the conical impression post on the implant and gently
tighten the coping screw to retain the impression post.
The conical impression post is rotation-symmetrical and
does not require any specific orientation. Carefully rotate
the conical impression post in the implant until the cams
engage with the grooves of the implant. Hand tighten to
secure the coping.
Take a radiograph along the long axis of the implant to
ensure that the impression post is seated completely on the
shoulder of the implant (flat-to-flat seat).
Note:
The X-ray tube must be positioned perpendicular to the
implant prosthetic platform.
3
Make a full-arch impression
Try the custom impression tray or modified stock tray
to verify that the coping screw protruding from the
perforations are not interfering with the tray.
Syringe a medium or heavy body elastomeric impression
material around the coping body, leaving the screw
exposed. Load the tray with impression material and make
the impression.
Important:
Before the material sets, use your finger to wipe the
impression material from the top of the screw so it is
exposed for access.
4
Remove the coping screw and impression
After the impression material has set, loosen the coping
screws by hand or by using the 0.50 hex driver, pull the
coping screw back and then lift off the tray from the mouth.
Verify the impression material is completely adapted
around the pick-up copings.
Place the healing abutment immediately to prevent soft
tissue collapse.
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impression techniques
Open tray impression taking
send to lab
• Impression with the embedded conical
impression posts and the coping screws
• Bite registration
• Prescription with lab instructions
5
Lab step - Assemble the analog
Attach the appropriate conical lab analog to the conical
impression post and secure retention by hand-tightening
the coping screw using the .050 hex driver.
6
Lab step -Make a soft tissue model
Verify the coping and analog assembly are properly
connected. Apply lubricant where the soft tissue replica
material is to be applied. Syringe a soft tissue replica
material around the analog.
7
Lab step -Fabricate the stone model
Fabricate a working model in minimal expansion, high
hardness die stone. Articulate according to normal
laboratory procedures.
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impression techniques
Closed tray technique using the indirect transfer coping
The closed tray, also known as the indirect transfer method, is used to make a single or multiple-unit, implant-level impression
for fabrication of a working model. The biggest advantage of the closed tray method is that it is easier to apply in the clinic and
there is no need for an individual tray. Since a prefabricated tray is used, the thickness of the impression materials around the
impression post is greater, thus providing more support and a more stable impression.
component options
• Conical impression post, closed tray
(including coping screw)
• Conical impression cap
• Conical lab analog
• .050” (1.25mm) hex driver
1
Remove the healing abutment
Remove the healing abutment using an .050” hex driver.
Confirm the implant prosthetic platform is free of any bone
debris or soft tissue.
Note:
If a custom cast is planned, the emergence will be
determined by the lab prescription.
Helpful Hint:
When placing impression posts on multiple implants,
remove one healing abutment at a time, replacing it
immediately with the closed tray impression post. This
reduces the likelihood of soft tissue collapse onto the
implant. It is recommended to work from posterior to
anterior.
2
Place the conical impression post (closed tray)
Hand-tighten the conical closed tray impression post on the
implant. The conical closed tray impression post is rotationsymmetrical and does not require any specific orientation.
Carefully rotate the impression post in the implant until the
cams engage with the grooves of the implant and gently
hand-tighten (10-15 NCm) the coping screw to retain the
impression post.
Take a radiograph along the long axis of the implant to
ensure that the impression post is seated completely into
the grooves of the implant.
Note:
The X-ray tube must be positioned perpendicular to the
implant prosthetic platform.
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impression techniques
Closed tray technique using the indirect transfer coping
3
Place the impression cap
Place the appropriate impression cap onto the conical
closed tray impression post using the guide grooves until
a detectable pressure point is reached and the impression
cap is clearly fixed into place. Orient the wings of the
impression cap to be buccal-lingual.
Note:
Three guide grooves on the impression post (each at
120°) allow for a contact-free placement with respect
to the adjacent impression caps or adjacent teeth. The
extensions of the impression caps must not be removed.
4
Make a full-arch impression
Right before taking the impression, check again to ensure
that the impression caps are seated correctly.
Syringe a medium or heavy body elastomeric impression
material around the coping body, leaving the screw
exposed. Load the tray with impression material and make
the impression.
After the impression material has set, remove the tray
from the mouth. The impression caps must stay in the
impression after the impression tray has been removed. If
this is not the case, take the impression again.
5
Remove the impression post
Loosen the coping screws by hand or by using the .050"
hex driver, pull the coping screw back and then remove the
conical closed tray impression post from the implant. Place
the healing abutment immediately over the implant to
prevent soft tissue collapse.
To prevent the loss of the coping screw, attach the
corresponding lab analog to the conical closed tray
impression post using the .050" hex driver.
send to lab
• Impression with the embedded impression cap
• Conical closed tray impression posts with the lab
analog attached
• bite registration
• prescription with lab instructions
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impression techniques
Closed tray technique using the indirect transfer coping
6
Lab step - Assemble the impression post
Position the assembled impression post and lab analog on
the impression caps embedded in the impression. Make
sure that the grooves correctly engage in the impression
cap and do not use bonding material.
7
Lab step - Make a soft-tissue model
Verify the coping and analog assembly are properly
connected. Apply lubricant where the soft tissue replica
material is to be applied. Syringe a soft tissue replica
material around the analog.
8
Lab step - Fabricate the stone model
Fabricate a working model in minimal expansion, high
hardness die stone. Articulate according to normal
laboratory procedures.
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introduction
Bite registration
The bite registration is taking an impression of a patient’s upper and lower teeth in the bite position to assist in the making and
fitting of restorations.
component options
• Conical impression post, closed tray (including
coping screw)
• Conical bite registration cap
• Stone impression models (lab analogs embedded)
• .050” (1.25mm) hex driver
1
Place the impression post
Place the conical impression post on the lab analog
embedded in the stone model. Hand tighten the impression
post using the coping screw and the .050" hex driver.
2
Install bite registration cap
Install the bite registration cap on the impression post.
Ensure that the bite registration cap is fully seated on the
impression post.
Note:
Correct seating of the bite registration cap on the
impression post is indicated by a perceptible locking feel.
3
Perform bite registration
Mount the stone models in an articulator tool and place the
bite register. Perform the bite registration using a tabletop
scanner.
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temporary restorations
Screw-retained crown using the conical temporary abutment
Use this technique for the fabrication of a multiple unit implant-supported, screw-retained hybrid in a partially or fully
edentulous patient.
component options
•
•
•
•
1
Conical temporary abutment
Abutment screw
.050” (1.25mm) hex driver
Torque wrench
Remove the healing abutment
Remove the healing abutment using an .050” (1.25mm) hex
driver. Make sure the prosthetic platform is free of bone
and soft tissue.
2
Seat the temporary abutment
Seat the temporary abutment, engaging the conical grooves
of the implant. Hand tighten the abutment screw using an
.050” (1.25mm) hex driver.
3
Mark the abutment
Evaluate inter-occlusal dimensions, angulation, and tissue
contour. Mark the abutment for the required vertical
reduction and gingival contour.
Important:
Abutments with a post height less than 4.0 mm are
intended for multi-unit restorations only.
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temporary restorations
Screw-retained crown using the conical temporary abutment
4
Modify the abutment
Remove the marked abutment from the site using an
.050” (1.25mm) hex driver. Modify the abutment for
vertical clearance and gingival margins using a carbide
bur. An analog can be used as a handle during abutment
modification.
Note:
Replace the healing abutment immediately to prevent soft
tissue collapse over the implant.
5
Seat the modified abutment
Verify the implant prosthetic platform is free of bone and
soft tissue. Irrigate the internally-threaded connection
of the implant and dry. Place the modified temporary
abutment onto the implant using the abutment screw
and an .050” (1.25mm) hex driver. Hand tighten.
6
Try in the shell crown
Try in the appropriate polycarbonate/shell crown and
modify as needed.
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temporary restorations
Screw-retained crown using the conical temporary abutment
7
Create an access hole
Remove the abutment screw from the modified abutment
and replace it with the block out screw. Create a screwaccess hole through the shell crown allowing the block out
screw to come through. Hand-tighten.
8
Fill the shell crown
Mix acrylic or another material of choice and place inside
the shell crown. Position the shell crown over the block out
screw onto the modified temporary abutment.
Note:
Undercuts on adjacent teeth should be blocked-out prior
to this reline procedure.
9
Remove and polish the crown
Remove the block out screw and the relined shell crown.
Place the screw-retained temporary crown onto an
analog using the abutment screw. Contour and polish the
temporary crown.
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temporary restorations
screw-retained crown using the Conical temporary abutment
10 Re-seat the crown
Make sure the implant prosthetic platform is free of bone
and soft tissue. Irrigate the internal connection of the
implant and dry. Try in the prosthesis to confirm fit and
contour. Modify as necessary and polish after making
necessary adjustments. Re-seat the prosthesis onto the
implant and hand tighten the abutment screw using an
.050” (1.25mm) hex driver.
Note:
Take a radiograph along the long axis of the implant
to ensure the abutment is seated completely onto the
implant.
11
Check and modify the temporary
Check the occlusion and contacts. There should only be
light contact in centric occlusion and no contact in lateral
excursions. Modify as necessary and polish after making
necessary adjustments.
12
Tighten the abutment screw
Tighten the abutment screws to 20 Ncm using a calibrated
torque wrench and an .050” (1.25) hex driver.
13
Fill the screw access channel
Place a resilient material of choice (gutta-percha, silicone or
temporary filling material) into the screw access channel.
This allows for easy access to the abutment screw in the
future. Fill the remainder of the channel using a composite
resin material of choice.
Take an x-ray for temporary prosthesis delivery records.
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cement-retained restorations
Cement-retained single crowns using esthetic abutments
Use this technique for a laboratory-modified cementable abutment. The clinician makes an implant-level impression; the lab
prepares the abutment and fabricates the restoration.
component options
• Conical esthetic abutment
• .050” (1.25mm) hex driver
• torque wrench
1
Make an implant-level impression
Remove the healing abutment and follow the steps for
creating an implant-level impression following either the
open tray technique or the closed tray technique.
2
Lab step - Pour the working model
Fabricate a working model following conventional
laboratory procedures. A soft tissue model is
recommended whenever the margins are subgingival.
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cement-retained restorations
Cement-retained single crowns using esthetic abutments
3
Lab step - Select and mark the abutment
Select an abutment based on implant location, tissue
depth and doctor preference. Seat the abutment, engaging
the conical grooves of the implant analog in the mounted
working model. Hand tighten the abutment screw with
an .050” (1.25mm) hex driver. Evaluate inter-occlusal
dimensions, angulations, and tissue contour. Mark the
abutment for the required vertical reduction and gingival
contour.
Note:
Allow a minimum of 1.5 – 2.0mm of occlusal clearance for
metal and porcelain.
4
Lab step - Modify the abutment
Modify the abutment using carbide burs, cut-off disks, or
heatless stone wheels. A diamond bur may be used to
define the margins. An analog can be used as a handle
during abutment modification.
Note:
Create an axial groove to indicate the buccal surface for
re-indexing the abutment in the mouth. If the flat of the
abutment is removed during the preparation, a new antirotational feature must be established on the abutment.
Important:
For cement-retained restorations, maintain at least
3mm from the abutment platform to avoid damaging
the abutment screw.
5
Lab step - Return the abutment to the model
Return the modified abutment to the mounted working
model and make final adjustments. A diamond bur may be
used to modify and finesse margins.
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cement-retained restorations
Cement-retained single crowns using esthetic abutments
6
Lab step - Wax the coping, sprue, invest and cast
In preparation to wax and cast the coping, block out the
screw-access hole of the prepared abutment and apply die
spacer.
Create a wax coping for the crown on the modified
abutment utilizing routine crown & bridge procedures.
Sprue, invest and cast the coping pattern in noble or high
noble alloy according to the manufacturer’s instructions.
7
Lab step - Divest and finish the coping
Divest, fit, and finish the cast coping following conventional
laboratory techniques in preparation for porcelain
application.
8
Lab step - Fabricate the crown
Apply opaque and porcelain to the metal framework
and complete the crown according to routine laboratory
procedures.
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cement-retained restorations
cement-retained single crowns using esthetic abutments
9
Seat the prepared abutment
Sanitize modified abutment and crown per standard clinical
procedure. Remove the healing abutment or provisional
prosthesis from the implant with an .050” (1.25mm) hex
driver. Make sure the implant prosthetic platform is free
of bone and soft tissue. Irrigate the internally-threaded
connection of the implant and dry. Place the modified
abutment and abutment screw onto the implant with an
.050” (1.25mm) hex driver and hand tighten to 10-15Ncm.
Take a radiograph along the long axis of the implant to
ensure the abutment is seated completely in the conical
grooves of the implant.
Note:
The X-ray tube must be positioned perpendicular to the
implant prosthetic platform.
10 Tighten the abutment screw
Tighten the abutment screw to 20 Ncm using a calibrated
torque wrench and an .050” (1.25) hex driver. Apply
counter-torque by grasping the abutment with an
abutment clamp.
11
Cement the final crown
Place a resilient material of choice (gutta-percha, silicone or
temporary filling material) into the screw access hole and fill
the remaining channel with composite or another material
of choice. This allows for easy access to the abutment screw
in the future.
Place the final restoration onto the abutment prior to
cementation. Check the occlusion and contacts. There
should only be light contact in centric occlusion and no
contact in lateral excursions.
Modify as necessary and polish after making necessary
adjustments.
Important:
Take an x-ray for final prosthesis delivery records.
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full-arch restorations
Multi-unit abutment hybrid or fixed-detachable screw-retained restoration
Use this technique for the fabrication of a multiple unit implant-supported, screw-retained hybrid in a partially or fully
edentulous patient.
component options
• Conical multi-unit abutment
(angled and straight)
• .050" (1.25mm) hex driver
• Torque wrench
• Multi-unit direct pick-up
impression copings
1
Select the abutments
Measure the tissue depth from the top of the implant to the
top of the tissue at its highest point. Select a conical Multiunit abutment with a collar height which is 1-2mm taller
than what is measured and matches the platform size and
angulation needed for proper coping position.
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full-arch restorations
Multi-unit abutment hybrid or fixed-detachable screw-retained restoration
2
Place the abutments
Remove the healing abutments using an .050” (1.25mm)
hex driver.
Straight abutments: Seat each straight abutment using
the carrier, threading it clockwise onto the implant body.
Bend the carrier to release it from the abutment.
Hand tighten the abutment using the manual Multi-unit
hex adapter.
Angled abutments: Transfer the MUA to the mouth using
the attached delivery handle. The abutment screw may be
tightened without removal of the delivery handle. Once
the abutment is secured in place, the delivery handle
should be removed and discarded.
Important:
When placing an angled Multi-unit abutment, rotate the
abutment and choose one of the six positions that best
corrects the implant angle.
Take a radiograph along the long axis of the implants
to ensure that the Multi-unit abutments are seated
completely.
Note:
The X-ray tube must be positioned perpendicular to the
implant prosthetic platform.
Straight abutments: Tighten the abutments to 20 Ncm
using a calibrated torque wrench and the 4mm square hex
adapter. The Multi-unit handpiece hex adapter can be used
with a compatible torque wrench.
Angled abutments: Tighten the abutment screw to 20 Ncm
using a calibrated torque wrench and an .050” (1.25) hex
driver.
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full-arch restorations
Multi-unit abutment hybrid or fixed-detachable screw-retained restoration
3
Make an abutment-level impression
Create an abutment-level impression.
Important:
The fabrication of a verification jig is recommended to
ensure the accuracy of the master stone model.
4
Lab step - Fabricate working model
Fabricate a working model following conventional
laboratory procedures. A soft tissue model is
recommended whenever the margins are subgingival.
5
Lab step - Fabricate verification jig
Using multi-unit direct pick-up copings or titanium copings,
fabricate a verification jig to verify the accuracy of the
working model.
Send the completed verification jig to the clinician for try-in.
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full-arch restorations
Multi-unit abutment hybrid or fixed-detachable screw-retained restoration
6
Try-in the verification jig
Remove the healing caps from the Multi-unit abutments
using an .050” (1.25mm) hex driver. Confirm the prosthetic
platform is free of any debris or soft tissue.
Place the verification jig and confirm that it seats passively.
Beginning with the most distal implant, place the first
abutment screw. Hand tighten the screw and make sure
the prosthetic interface on all the remaining implants are
completely seated.
Note: Visually or with a radiograph, always ensure the
verification jig is completely seated onto the implants or the
abutments.
Continue placing the abutment screws. Verify the fit each
time a screw is placed.
7
Lab Step - Digital conversion
Once the accuracy of the working model has been verified,
place Multi-unit titanium scan bodies on the analogs using
an .050" (1.25mm) hex driver.
Conduct the scan according to the scanner manufacturer’s
instructions. Then, using the relevant digital library, align
the scan body by selecting identifiable reference points.
8
Lab step - Mill restoration
Send the scan files to a BioHorizons validated milling
center.
2300 Riverchase Center, Suite 825
Birmingham, AL 35244
Phone: 844-484-2301
Website: www.vulcandental.com
Email: [email protected]
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custom CAD/CAM restorations
SmartShape™ Healers digital & closed-tray impression workflows
The BioHorizons SmartShape healing system offers an anatomically designed healing abutment solution that is
also integrated within digital restorative workflows. Healers are available in different profiles that are contoured
to match natural tooth shapes to provide more esthetic tissue shaping. Once placed, the SmartShape healer can
be scanned or impressed to transfer the implant position to a model. Custom abutments can be milled to match
the anatomical profile of each healer and maintain the tissue contouring with the final restoration.
Easy identification & selection
SmartShape Healers are available in 6 different anatomical profiles across the two BioHorizons conical
connections (narrow and regular). Two height options are available to accommodate varying tissue thicknesses
and implant placement protocols.
Shape
Connections
Heights
A1
Maxillary Centrals
(Sites 8, 9)
Regular & Tall
A2
Maxillary Laterals & Mandibular Incisors
(Sites 7, 10, 23-26)
Regular & Tall
M1
Maxillary Canines
(Sites 6,11)
Regular & Tall
M2
Premolars & Mandibular Canines
(Sites 4-5, 12-13, 20-22, 27-29)
Regular & Tall
P1
Maxillary Molars
(Sites 2-3, 14-15)
Regular & Tall
P2
Mandibular Molars
(Sites 18-19, 30-31)
Regular & Tall
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custom CAD/CAM restorations
SmartShape™ Healers digital & closed-tray impression workflows
SmartShape Healer selection is determined by
the anatomical position in the mouth for the best
match between natural dentition and the abutment
emergence profile.
A1
A2
A1
A2
M1
M1
M2
M2
M2
A1- Anterior 1
A2- Anterior 2
M1- Mid 1
M2
P1
P1
P1
P1
P2
P2
P2
M2- Mid 2
P1- Posterior 1
P2- Posterior 2
P2
M2
M2
M2
M2
M2
A2
A2
A2
A2
M2
The implant platform is indicated by dimples
on the occlusal surface.
1 Dimple
Narrow platform
2 Dimples
Regular platform
Important:
A notch is marked on the occlusal surface for indexing
the healer profile and identifying the healer height.
The healer should be placed so the notch is
perpendicular to the buccal plane.
Different tissue heights offer a solution for two implant
position/depth options for varying tissue thickness and
implant placement protocols.
I
Regular height
T
Tall height
L02093-050 REV B SEP 2024
Page 2 of 6
Notch
Buccal plane
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Digital impressions using SmartShape Healers
1
SmartShape Healer placement
Confirm the implant prosthetic platform is free of any
bone debris or soft tissue. Place the SmartShape Healer
with the occlusal notch perpendicular to the buccal
plane. Verify the healer is fully seated, then hand tighten
the screw with a .050" (1.25mm) hex driver.
Important:
Make sure the SmartShape Healer is seated properly,
leaving the scannable surface a minimum of 0.5mm
above the soft tissue.
0.5mm
Scannable surface
Soft tissue
Helpful hint:
Take a radiograph along the long axis of the implant to
ensure that the healer is seated completely into the hex
of the implant. Note: The X-ray tube must be positioned
perpendicular to the implant prosthetic platform.
L02093-050 REV B SEP 2024
Page 3 of 6
Bone
customer care:
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custom CAD/CAM restorations
Digital impressions using SmartShape Healers
2
Digitize the impression
Confirm the occlusal surface of the SmartShape Healer
is free of any residue or debris. Take an intraoral digital
impression of the healer and surrounding dentition
using a handheld 3D scanner.
Important:
Ensure the lab has the digital library that is compatible
with the scan body. The BioHorizons digital library can
be downloaded from vulcandental.com/DigitalLibraries.
Import into CAD software
• Digital impression of SmartShape Healer
• Opposing intraoral scan or model
• Prescription with lab instructions including
SmartShape Healer height, anatomical shape
and platform size (or product code)
3
Verify alignment & platform size
Correct alignment
Correct alignment is indicated by a match between the
SmartShape Healer and scan throughout all regions. This
requires selecting the correct anatomical shape, platform
and height, which should be recorded in the prescription.
Once the platform, height and alignment have been
verified, the lab can continue with the design process.
Helpful hint:
The occlusal dimples and notches are only used for
visual identification of the healer. Since these features
are not used in the digital alignment process, it is recommended to select points along the healer's anatomical
profile to initiate alignment.
Misalignment
Misalignment is visible in red when the incorrect shape
is selected. Visual confirmation is required to ensure that
the correct height (buccal notch) and platform (dimples)
have been selected.
L02093-050 REV B SEP 2024
Page 4 of 6
customer care:
888.246.8338
custom CAD/CAM restorations
Closed-tray impression using SmartShape Healers
1
SmartShape Healer placement
Confirm the implant prosthetic platform is free of any
bone debris or soft tissue. Place the SmartShape Healer
with the occlusal notch perpendicular to the buccal
plane. Verify the healer is fully seated and hand tighten
the screw with a .050" (1.25mm) hex driver.
Important:
Make sure the SmartShape Healer is seated properly,
leaving 0.5mm of the scannable surface above the
soft tissue.
Helpful hint:
Take a radiograph along the long axis of the implant to
ensure the abutment is seated completely into the hex
of the implant. Note: The X-ray tube must be positioned
perpendicular to the implant prosthetic platform.
2
Make a full-arch impression
Syringe a medium-body elastomeric impression
material around and over the SmartShape Healer.
Load the tray with the same impression material and
take the impression.
After the impression material has set, remove the tray
from the mouth with the embedded impression of the
the SmartShape Healer.
Confirm no distortions are present on the impression
and that it captured the entire SmartShape Healer
occlusal surface and surrounding tissue.
Send to lab
• Impression of SmartShape Healer
• Opposing model or impression
• Prescription with lab instructions including
SmartShape Healer height, anatomical shape
and platform size (or reference number)
L02093-050 REV B SEP 2024
Page 5 of 6
customer care:
888.246.8338
custom CAD/CAM restorations
Closed-tray impression using SmartShape Healers
3
Lab step — scan the closed-tray impression
There are two primary ways to digitize the traditional
impression.
Option A: Pour a stone model from the impression
to replicate the abutment. Use a 3D tabletop digital
scanner to scan the stone model.
Option B: Use a 3D tabletop digital scanner to directly
scan the impression material. Note that this may require
specialized software or scanner settings.
4
Lab step — Verify alignment & platform size
Correct alignment
Correct alignment is indicated by a match between the
SmartShape Healer and scan throughout all regions.
This requires selecting the correct anatomical shape,
platform and height, which should be recorded in the
prescription. Once the platform, height and alignment
have been verified, the lab can continue with the design
process.
Helpful hint:
The occlusal dimples and notches are only used for
visual identification of the healer. Since these features
are not used in the digital alignment process, it is recommended to select points along the healer's anatomical
profile to initiate alignment.
Misalignment
Misalignment is visible in red when the incorrect shape
is selected. Visual confirmation is required to ensure that
the correct height (buccal notch) and platform (dimples)
have been selected.
L02093-050 REV B SEP 2024
Page 6 of 6
customer care:
888.246.8338
custom CAD/CAM restorations
Digital or traditional impression taking using conical titanium scan bodies
The Conical Titanium Implant-Level scan bodies are used for optical three-dimensional localization of Tapered Pro Conical
implants in the mouth and of the Conical lab analogs on a working model.
Note:
The use of the sterile scan body is limited to use in the mouth. The scan bodies may be used
multiple times on the working model taking the integrity of the scan bodies into account.
Intraoral
digital scan
acquisition
Send
to design
software
Design
of
restoration
Creation of
3D-printed
model
Creation
of printed
restoration
component options
• Conical implant-level Ti scan body
(including conical abutment screw)
• .050” (1.25mm) hex driver
1
Remove the healing abutment
Remove the healing abutment using an .050” hex driver.
Confirm the implant prosthetic platform is free of any bone
debris or soft tissue.
Helpful hint:
When placing scan bodies on multiple implants, remove
one healing abutment at a time, replacing it immediately
with the scan body. This reduces the likelihood of soft
tissue collapsing onto the implant. Work from the
posterior to the anterior.
L02093-044 REV A FEB 2025
Page 1 of 4
customer care:
888.246.8338
custom CAD/CAM restorations
Digital or traditional impression taking using conical titanium scan bodies
2
Place the implant-level scan body
Sterilize the scan body prior to use in-mouth. Place the
conical scan body on the implant and ensure that the
three (3) cams on the base of the scan body to lock into the
conical connection supported by the implant’s grooves.
Ensure that the scan body is sitting flush with the shoulder
of the implant and secure retention using the conical
abutment screw using a .050" hex driver.
Take a radiograph along the long axis of the implant to
ensure that the scan body is seated completely into the
implant.
Note:
The X-ray tube must be positioned perpendicular to the
implant prosthetic platform.
3
Perform intraoral scan
Scan the scan body and surrounding dentition using
handheld 3D scanner. Once the scanning is complete, you
may import the digital file created to a design software or
share with the lab of your choice.
Important:
Ensure the lab has the digital library that is compatible
with the scan body. BioHorizons digital library can be
downloaded from vulcandental.com.
4
Replace healing abutment
Replace the healing abutment immediately to prevent soft
tissue collapse over the implant.
L02093-044 REV A FEB 2025
Page 2 of 4
customer care:
888.246.8338
custom CAD/CAM restorations
Creation of printed 3D model
component options
• Conical Implant-Level Ti Scan Body
(including conical abutment screw)
• .050” (1.25mm) hex driver
• Lab analog
• Lab analog insertion tool
1
Create 3D model for printing
Using a design software, import the digital file acquired
during the intra-oral scanning of the patient.
Complete the software steps to develop a 3D model and
print the 3D model following the appropriate steps of
printing, drying, and curing of the model per the hardware
manufacturer's recommendations.
2
Insert lab analog
Once the 3D printed model is ready for manipulation,
insert the lab analog insertion tool in the conical lab
analog and secure retention by tightening the lab analog
insertion tool.
Hold the lab analog insertion tool and insert the lab analog
into the 3D printed model by pressing it down.
3
Verify model accuracy
To ensure that the 3D printed model is an accurate
depiction of the patient’s oral anatomy, conical titanium
scan bodies may be placed on the lab analogs using the
conical abutment screws and hand-tightened with an .050
hex screwdriver.
A comparison digital scan may be acquired using a tabletop scanner or a handheld scanner.
Note:
Conical Titanium Scan Bodies may be used repeatedly on
working models.
L02093-044 REV A FEB 2025
Page 3 of 4
customer care:
888.246.8338
custom CAD/CAM restorations
Design & mill of restoration
component options
• Conical Implant-Level Ti Scan Body
(including conical abutment screw)
• .050” (1.25mm) hex driver
• Conical block-out screw
• 3D-printed model
1
Create 3D design for restoration
Using a design software, import the digital file acquired
during the intra-oral scanning of the patient.
Complete the software steps to develop a 3D model of the
restoration and print the model following the appropriate
steps of printing, drying, and curing of the restoration per
the hardware manufacturer's recommendations.
2
Finalizing the restoration
Once the restoration is ready for manipulation, clean
the surface of the restoration and bond the restoration
to the abutment following the cement manufacturer’s
indications. The cement or bonding material should be
indicated for Zirconium dioxide ceramics or PMMA. The
conical block-out screw should be used to prevent cement
from entering the screw access channel.
Note:
Depending on the chosen abutment, it may be necessary
to modify the abutment prior to placing and bonding the
restoration on the abutment.
Important:
For single crowns with angled screw channels, the
final unused CAD/CAM Ti base abutment screw must
be inserted before bonding the final restoration. The
abutment screw is “trapped” by the bond and may not be
removed without destroying the superstructure.
3
Verification of restoration
Verify the design and accuracy of the restoration by
securing it to the lab analog on the 3D printed model
using the conical abutment screw hand-tightened with
the .050" hex driver. Check the contacts. Modify as
necessary and polish after adjusting.
L02093-044 REV A FEB 2025
Page 4 of 4
customer care:
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ordering & warranty information
Product Support Specialist:
Cell phone:
Fax:
Territory Manager:
Cell/mobile phone:
Email and/or fax:
BioHorizons Lifetime Warranty on Implants and Prosthetics for Clinicians: All BioHorizons implants and prosthetic
components include a Lifetime Warranty.BioHorizons implant or prosthetic components will be replaced if removal of that
product is due to failure (excluding normal wear to overdenture attachments).
Additional Warranties: BioHorizons warranties surgical drills, taps and other surgical and restorative instruments.
(1) Surgical Drills and Taps: Surgical drills and taps include a warranty period of ninety (90) days from the date of initial invoice.
Surgical instruments should be replaced when they become worn, dull, corroded or in any way compromised. Surgical drills
should be replaced after 12 to 20 osteotomies.16
(2) Instruments: The BioHorizons manufactured instrument warranty extends for a period of one (1) year from the date of
initial invoice. Instruments include drivers, implant site dilators and BioHorizons tools used in the placement or restoration of
BioHorizons implants.
Return Policy: Product returns require a Return Authorization Form, which may be acquired by contacting Customer Care. The
completed Return Authorization Form must be included with the returned product. For more information, please see the reverse
side of the invoice that was shipped with the product.
Disclaimer of Liability: BioHorizons products may only be used in conjunction with the associated original components and
instruments according to the Instructions for Use (IFU). Use of any non-BioHorizons products in conjunction with BioHorizons
products will void any warranty or any other obligation, expressed or implied.
Treatment planning and clinical application of BioHorizons products are the responsibility of each individual clinician. BioHorizons
strongly recommends completion of postgraduate dental implant education and adherence to the IFU that accompany each
product. BioHorizons is not responsible for incidental or consequential damages or liability relating to use of our products alone
or in combination with other products other than replacement or repair under our warranties.
Distributed Products: For information on the manufacturer’s warranty of distributed products, please refer to their product
packaging. Distributed products are subject to price change without notice.
Validity: Upon its release, this literature supersedes all previously published versions.
Availability: Not all products shown or described in this literature are available in all countries. BioHorizons continually strives to
improve its products and therefore reserves the right to improve, modify, change specifications or discontinue products
at any time.
Any images depicted in this literature are not to scale, nor are all products depicted. Product descriptions have been modified for
presentation purposes. For complete product descriptions and additional information,
visit store.biohorizons.com.
customer care:
888.246.8338
Direct Offices
BioHorizons USA
888-246-8338 or 205-967-7880
BioHorizons Canada
866-468-8338
BioHorizons Spain
+34 91 713 10 84
BioHorizons UK
+44 (0)1344 752560
BioHorizons Chile
+56 (2) 23619519
BioHorizons Italy
800-063-040
BioHorizons Mexico
800-953-0498
Distributors
For contact information in our 90 countries, visit biohorizons.com
BioHorizons®, Laser-Lok®, MinerOss®, AutoTac®, Mem-Lok® and TeethXpress® are registered trademarks of BioHorizons. Unigrip™ is a trademark of Nobel Biocare AB. Zimmer®
Dental ScrewVent® and Tapered ScrewVent® are registered trademarks of Zimmer, Inc. AlloDerm™ and AlloDerm GBR™ are trademarks of LifeCell Corporation, an Allergan
affiliate. Grafton® DBM is a registered trademark of Medtronic, Inc. Cytoplast® is a registered trademark of Osteogenics Biomedical, Inc. Puros Dermis is a registered trademark
of Zimmer Biomet. Mucograft is a registered trademark of Ed. Geistlich Sogne Ag Fur Chemische Industrie. Symbios PerioDerm is a registered trademark of Dentsply Sirona.
Spiralock® is a registered trademark of Spiralock Corporation. Pomalux® is a registered trademark of Westlake Plastics Co. Locator® is a registered trademark of Zest Anchors,
Inc. Delrin® is a registered trademark of E.I. du Pont de Nemours and Company. Bio-Gide® is a registered trademark of Edward Geistlich Sohne AG Fur Chemische Industrie.
BioMend® is a registered trademark of Zimmer Biomet Dental. IntraSpin®, L-PRF® and Xpression® are trademarks of Intra-Lock® International Inc. Not all products shown or
described in this literature are available in all countries. We are proud to be registered to ISO 13485:2016, the international quality management system standard for medical
devices, which supports and maintains our product licences with Health Canada and in other markets around the globe. Original language is English.
©BioHorizons. All Rights Reserved.
shop online at
store.biohorizons.com
L02093 REV B FEB 2025
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