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metal-free restorations industry report | Fig. 35 Fig. 36 Fig. 37 Fig. 38 Fig. 39 Fig. 40 Fig. 41 Fig. 42 Fig. 43 in very satisfying radiological and clinical results (Figs. 30 & 31). The CAD/CAM planning and milling technology facilitate the manufacture of cemented, screwed (Figs. 32 & 33) or standardised copings with two different frictions (retentive or passive, Fig. 34). Meanwhile we supplied 20 patients suffering from atrophic maxilla class VI7 with 80 implants. We have lost three implants in an observation period of up to 3.2 years. The implant survival rate fell from 98.6 per cent in year one to 93.5 per cent in year three. As these three patients have worn their prosthesis on three implants until the fourth implant was replaced, these again are 100 per cent of prosthetic success. The following patient demonstration shows the CAD/CAM procedure to manufacture the retentive TRINIA telescopic prosthesis. After the first step comprising the set-up and clinical evaluation, in- cluding the wax fitting (Fig. 35), you need to choose the adequate angular difference of two to three de- grees to ensure sufficient friction (Fig. 36). A posi- tioning splint made of light-cure GC plastic helps positioning the abutment (Fig. 37). Three retentive copings suffice for sufficient friction of the tele- scopic prosthesis (Fig. 38). The next step is the CAD design (Fig. 39). After having manufactured the TRINIA framework in the CAM milling procedure, it is positioned between the telescopic copings and the synthetic teeth (Fig. 40) and then the framework is bonded to the teeth (Fig. 41). Figures 42 and 43 show the finished 12-piece telescopic prosthesis. In the meantime, we have installed either multi- part bridges or complete prostheses made of TRINIA material in altogether 101 patients. In the obser- vation period of 64 months, the material did not chip yet and only one broke. Conclusion The observation period of 64 months for 101 TRINIA bridges and prostheses allows the conclusion that this is a method comparable to metal ceramic restorations._ Editorial note: A list of references is available from the publisher. Fig. 35: Set-up of the mandibular prosthesis in the articulator. Fig. 36: Measuring the angular difference of two to three degrees in order to achieve adequate friction. Fig. 37: Positioning splint for position- ing the abutment (numbers show the sequence of the abutment insertion) with relation to the implant axes. Fig. 38: Only three retentive telescope caps (violet) are necessary for a save retention. Fig. 39: Computer image of the TRINIA construction’s CAD design. Fig. 40: The milled TRINIA construction is positioned between the abutments TRINIA is a registered trademark of Bicon USA. and the synthetic teeth. contact Prof. Dr Rolf Ewers Chairman of CMF Institute Vienna Schumanngasse 15 1180 Vienna, Austria rolf@cmf-vienna.com www.cmf-vienna.com Prof. Dr Mauro Marincola Via dei Gracchi, 285 00192 Rome, Italy Dr Vincent J. Morgan DMD/Boston Fig. 41: The synthetic teeth are fixed on the TRINIA construction. Fig. 42: Caudal view on the completed TRINIA prosthesis. Fig. 43: Occlusal view on the com- pleted 12-piece TRINIA prosthesis. CAD/CAM 3 2017 37