Raising the Bar to Meet Demand For Implant-Supported Dentures

Frank Munzenmayer, CDT · Technical · Apr 2012

To meet the demand for implant-supported, removable full dentures among the rapidly growing aging population, Cendres+Métaux has redesigned the concept of an implant-supported bar system with its Stress Free Implant (SFI) Bar®. All the components are pre-fabricated so no casting, soldering, laser welding or milling are required, making the SFI Bar® advantageous over conventional bar systems.

Since November of 2006, over 4,000 SFI Bars® have been placed intraorally throughout Europe and Asia with a track record of zero remakes or complications. Recently, the first cases have been placed in the U.S. as well.

Based on Swiss technology, the SFI Bar® is designed for both jaws and ensures a stress-free hold of the prosthesis, enhancing stability and patient comfort. The bar is measured and precisely cut to size according to the distance between the implants. It's supported by ball joints that are adapted to the abutments, which in turn are attached to the implants. With the appropriate abutments, the SFI Bar® can be used with any implant situation.

Following is the technique for restoring an edentulous patient who was dissatisfied with the retention of the lower denture due to the shallow ridge. The treatment plan called for placing four implants and using the SFI Bar® System to improve retention, comfort and esthetics.

The SFI Bar® from Cendres+Métaux is pre-fabricated for use with two-implant and four-implant cases. Due to its prefabricated length, the farthest the implants can be placed from each other is 28mm; the closest recommended distance is 8mm. Although the SFI Bar® technique and procedure may be handled intraorally, assembling it on the model is recommended; it's less stressful for the patient who has just gone through the trauma of having implants inserted.

System components include:

• The Tube Bar is made of Type 5 titanium and is 20mm long. Load tests conducted at the University of Bonn in Germany show that a two-implant solution with anchoring the bar on two implants is able to safely withstand a load of 500N; a four-implant solution, with the bars following the alveolar ridge, can withstand a load of 1,500N (500N/bar). To read the complete scientific study, visit www.sfi-bar.com.

• Large Ball Joints support the tube bar between two implants. They also allow for an angulation forgiveness of 15° in either direction, meaning a total of 30° between two implants.

• Small Ball Joints support the two bars between three implants and have two stems. They're able to support a lateral angulation from 110° to 150°. Unlike the large ball joint, they're designed with a half-shell casing; like the large ball joint, they allow for an angulation forgiveness of 15° in either direction.

• Fixation Screw secures the ball joints to the implant adaptor and has an internal hex of 1.32mm and is 5.30mm in length.

• Implant Adaptor is specifically designed and shaped to adapt to the implant brand being used. It supports the ball joint that will be secured by the fixation screw that screws into the adaptor that will support the entire SFI Bar® to the implants.

All the components are available separately; this means more bars may be added to accommodate additional implants for the current case or that may be placed in the future.

For more information, call 888-554-5504 or visit www.cmsa.ch/dental

Frank Munzenmayer, CDT, Technical Education Manager at Cendres+Métaux USA, has an extensive background in dental technology. A graduate of the New York City College of Technology, he worked as a C&B technician for 10 years, managed Technical/Education Departments and has been a Technical Advisor for six major dental manufacturers.

I would like to thank the following for their contributions to this article: Dr. L. Keilig; Dr. K. Tibak; Dr. A. Aderset; Dr. M. Gruner; Dr. H. Stark; Dr. C. Bourauel; Dr. N. Enkling; Dr. S. Bayer, Department of Prosthetic Dentistry, Preclinical Education and Materials Science and CM Endowed Chair of Oral Technology, University of Bonn Germany; Professor Ludwig, University of Kiel; and Bernard Guggisberg, MDT, Cendres+Metaux, Switzerland.

© 2013 LMT Communications, Inc. · Articles may not be reprinted without the permission of LMT

Step-By-Step

  • Figure 1A The implants are prepared to be picked up in the impression.

  • Figure 1B The implants are prepared to be picked up in the impression.

  • Figure 2 Once the model is prepared, the proper adaptor heights for a perfect alignment of the bar to the occlusal plane are selected. The goal is to achieve at least a 1mm clearance between the bar and the tissue. The available adaptor heights range from 1mm to 5mm; for this case, two 1mm, one 2mm and one 3mm adaptors are used.

  • Figure 3A The tube bars are detached. Notice that the small ball joints have two stems to accommodate more than one bar. These will be attached to the anterior implant adaptors with the hex screwdriver; the larger ball joints will be attached to the posterior implant adaptors.

  • Figure 3B The tube bars are detached. Notice that the small ball joints have two stems to accommodate more than one bar. These will be attached to the anterior implant adaptors with the hex screwdriver; the larger ball joints will be attached to the posterior implant adaptors.

  • Figure 4 The large ball joint is screwed onto the implant adaptor and only slightly tightened.

  • Figure 5 The tube bar is attached to the ball joint. The tube bar measuring gauge is adapted to the bar which is then measured to the precise length by resting the tube bar gauge to the adjacent implant adaptor.

  • Figure 6 Once the desired length of the bar is determined, the screw on the tube bar gauge is tightened which locks in the desired bar length.

  • Figure 7 The bar is secured to the measuring gauge and sectioned with the separating disk.

  • Figure 8 The sectioned bar is adapted to the large ball joint and connected to the stems of the large and small ball joints.

  • Figure 9 The procedure is repeated for the remaining tube bars.

  • Figure 10 Since the minimum distance allowed by the SFI Bar® System is 8mm between implant centers, it’s necessary to cut the supporting joints between the ball joints. The ball joints are placed on the model, the joint stems are placed parallel and cut directly on the model.

  • Figure 11 The titanium clip is pre-measured and sectioned to hold one insert per section. The maximum number of full sections is measured and cut to size.

  • Figure 12 After the clip has been sectioned, the vinyl inserts are placed in the clip with the insertion tool provided. The vinyl inserts are available in three retention strengths and color-coded accordingly: yellow is light, red is medium and green is high.

  • Figure 14 For this case, the red vinyl inserts are positioned in the sectioned clips and the clips are positioned onto the assigned bar. The denture is placed on the model and the clips are incorporated into the denture with cold-cure acrylic. The denture is trimmed and polished, and the case is delivered to the doctor’s office for insertion.

  • Figure 15A The denture is now ready for final insertion in the mouth.

  • Figure 15C The denture is now ready for final insertion in the mouth.

  • Figure 12C The denture is now ready for final insertion in the mouth.

About the Author
Frank Munzenmayer, CDT

Technical Education Manager

Frank Munzenmayer, CDT, Technical Education Manager at Cendres+Métaux USA, has an extensive background in dental technology. A graduate of the New York City College of Technology, he worked as a C&B technician...See more

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