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TSA – The Biomechanical Abutment Dr. Thomas Laux 1984-1989 Studied dentistry at the University of the Olympic city of Sarajevo 1990-1998 Dentist at implant clinic in Hamburg focusing biomechanics. From 1999 Practicing dentistry in Augsburg. Management of the IMPLANT Diagnostic Centre in Augsburg. Three patents granted in the field of oral implantology. Inventor of the BoneCare ™ titanium shock absorbers.

Tsa biomechanical abutment

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TSA – The Biomechanical Abutment

Dr. Thomas Laux

1984-1989 Studied dentistry at the University of the Olympic city of Sarajevo

1990-1998 Dentist at implant clinic in Hamburg focusing biomechanics.

From 1999 Practicing dentistry in Augsburg. Management of the IMPLANT Diagnostic Centre in Augsburg. Three patents granted in the field of oral implantology. Inventor of the BoneCare ™ titanium shock absorbers.

The natural chewing function is a dynamic process: anatomical structures such as mucosa, muscles, periodontal ligament and even the lower jaw have a certain elasticity which absorbs and transfers the forces related to chewing.

When, with implants, the natural ligament is not present (ankylosis), physiological mobility (max.2 micron) is no longer possible. In that case, mechanical overloading is the logical consequence. This entails an increased risk of fracture of the implant, the abutment, the screw as well as the restoration. This overloading is also considered to be an aetiological cofactor for the development of periimplantitis.

TSA – Abutment: Movement

BRIDGE WORK► 20 micron vertical movement

► 45 micron horizontal movement

OVERDENTURE► 150 micron vertical movement► 45 micron horizontal movement

Special adhesive technology

The TSA abutment, with its unique resilience, will prevent these problems. The abutment is completely sealed off from the environment of the mouth, and its mobility provides the underlying soft tissue with a micro-massage.

10x TSA in a Chewing Simulator University of Munich

2001

2012

Implant-Tooth-Connection

TSABiomechanical Abutment

Implant-Tooth-Connection

Christiaan Berghmans,

TSA abutmentFEM - Model

FEM - Modelridged abutment

TSA curve

Using the resonance frequency analysis of Osstell, changes in stiffness and stability of the implant / bone interface can be monitored and measured. Data collected since mid-2003 of the multi-center study shows, that approximate the initially different implant stability Quozienten (ISQ) for immediate loading and immediate restoration with the BoneCare ® titanium shock absorber, are increasing. Moreover, since that time, no prosthesis is broken. Non of the 82 implants was lost. The controll group of the multi-centre-study is the study of Roland Glauser et al. (Zurich). He made the study on ridged abutments. He lost 11 of 82 implants.

Multi-Centre-Study

TSA – Friction Sleeve System

EXTRA LOW LOW MIDDLE HIGH SECUNDARY CAP CONE

TSA – Friction Sleeve System

CONE

Abutment level impression: fixation in the mouth

After making an impression, remove healing abutments and determine the correct height of the TSA abutment. The basic principle here is that the shoulder of the abutment must come to the same level as the highest point of the surrounding mucosal tissues. If, when using the TSA abutment, as opposed to other anchoring systems, there is insufficient space, the shoulder of the abutment can be placed 1 mm lower. The functioning of this abutment allows the secondary cap to be partially positioned under the mucosal tissue.

Definitive positioning of the abutments and tightening with a force of 25 Ncm.

Positioning of the spacer caps.

Functional impression with individual tray and conventional impression materials. Ensure that there are enough recesses for the spacer caps in the tray. Be careful for air bubbles around the caps.

Remove impression. Do not reposition the spacer caps in the impression. Remove the spacer caps that remain in the impression.

Cast the definitive model. Bite plate and fitting in wax according to the conventional method.

Before moulding the prosthesis ensure that only the undercuts under the stumps (spacer) are blocked out. The spacer ensures that sufficient space is created so that the prosthesis can be positioned without friction and unambiguously over the secondary caps in the mouth. The space needed to apply the fixation material is also uniform, resulting in optimal fixation. The roughening of the recesses for the application of the adhesive strengthens the bond between the gel and the prosthesis.

As standard procedure, screw a metal-coloured sleeve using the tool in the secondary cap. Be careful to ensure that the friction sleeve is completely seated on the secondary cap.

Then mount the rubber dam under the sealing edge of the secondary cap. Press the secondary cap over the abutment until a clear 'click' (circle snap) is audible. Repeat this procedure for the remaining caps. Finally, ensure that the rubber dam tightly fits against the mucosal tissue. Then check whether the prosthesis is positioned properly on the mucosal tissue before checking the occlusion. Remove any pressure points. Blow the secondary caps dry before applying the etching material; e.g., Metal Primer from GC (see manufacturer's instruction for use). Etching ensures optimal fixation.

Roughen the inside of the recesses with a spherical bur, fill with an adhesive and allow to dry briefly. The adhesive provides for the optimal bonding between the plastic of the prosthesis and the composite. The fixation of the secondary cap in the mouth is achieved using, e.g. Quick Up from Voco or a similar product. It is supplied in a cartridge and with an adhesive. The advantage of the gel is that it does not harden too quickly, and due to uniform dosing, it always has the same strength. With the aid of a dispenser, a small amount of gel is applied to the recess. Be sure not to completely fill the recess; filling it one-third is the recommended amount.

Place the prosthesis in the mouth and have the patient set the teeth in a position of central occlusion. It is important that no force is exerted by the patient during the hardening. After hardening, check occlusion and articulation.

Click out the prosthesis and then remove the rubber dam and the excess material. Reposition the prosthesis and check the friction.

Replace the extra low friction sleeves with sleeves of the suitable friction level.

Coverdenture without metal frame

Coverdenture without metal frame

Removable Bridgework

Removable Bridgework

TSA-MAX single tooth

Thank you for your attention!