DELIVER OVER DENTURE TYPE "B"

Assembled bar
Inventory all parts received from the laboratory immediately after
arrival of the case in the office. Are the correct number of final
screws included and are they in the original packaging? Assemble
the bar on the working model using only one screw in a terminal
implant. Hand tighten the screw and examine if the restoration seats
passively on all implants with just one screw tightened. Ensure all
screws pass through the access channels without binding.

Torque wrench
Determine appropriate torque requirements for the final screws. Some
implant manufacturers have different torque specifications depending on the
implant diameter. In case the restoration is a large span bridge, intermediate
abutments (abutment for screw by Biohorizons, multi unit abutment by Nobel
Biocare™, standard abutment by Biomet 3i™ a.o.) may be already in place or need
to be placed before the restoration is seated. Torque requirements for the

Intermediary abutment
intermediate abutments are usually the same as for standard abutments but the
final screw fixing the restoration to the intermediate abutments is usually much
lower (10Ncm to 15Ncm). Have torque wrench with appropriate
driver tip on hand. Laboratories often offer torque wrenches for a nominal
rental fee or contact your local implant manufacturers account representative.
Familiarize yourself with the torque wrench, torque settings and how it works.
In most instances it is not necessary to anesthetize the patient for the
delivery of the restoration unless tissue recontouring around the implants
is planned. Remove any temporary restorations, temporary abutments or
trans mucosal healing abutments. Irrigate the inside of the implant with
chlorhexidine and flush out any debris.

Delivered bar
Place the bar in the patients mouth on to the implants,
using only one screw in a terminal implant. Hand tighten the screw and
examine if the bar seats passively on all implants with just one
screw tightened. After passive fit of the bar is confirmed in the
patients mouth, hand tighten the remaining screws. Take a panograph to
ensure all components are seated and as a bone level baseline record.
Place denture over the bar in the patients mouth. Using pressure indicator
paste (udent®)
, indentify and relieve any pressure areas like a regular full denture.
Adjust occlusion and equalize lateral contacts. Torque all screws with
the torque wrench to implant manufacturers specification.
Wait a few minutes and torque the screws again to specification.