- 1.Fabricate an implant indexing device with parallel axial walls, a flat occlusal surface, and sufficient material surrounding the impression transfer copings (ACTDT; Zimmer Biomet). If cantilevers are anticipated, extend the implant indexing device as needed.
- 2.Evaluate the implant indexing device intraorally (Fig. 1) and verify the accuracy of the definitive casts. If a discrepancy is found at this stage, a new definitive impression is required.
- 3.Remove the implant indexing device from the patient’s mouth and spray it with a disinfecting solution (Cavicide1; Metrex). Replace the transfer screws (SCDTS; Zimmer Biomet) with coping screws (SCTS; Zimmer Biomet). Fix the implant indexing device to the verified definitive cast with the coping screws. Posteriorly, block the screw-access holes with polytetrafluorethylene (PTFE) tape or cotton pellets.
- 4.Embed the implant indexing device up to its middle in the zinc pellet container of a pressure molding device (BioStar; ScheuGroup), making sure to cover the undercuts and irregularities with zinc pellets. Copy the verification device surface with a thermoplastic polymer (1 mm/125 mm Round Clear Splint Biocryl; Great Lakes Orthodontics); do not remove the plastic lining because it will act as a separating medium (Fig. 2A).
- 5.Carefully remove and trim the pressure molded record base from the implant indexing device. Smooth the borders and any irregularities with a fine laboratory tungsten carbide cutter (H251ACR; Komet USA) and an abrasive buffing wheel (9485F; Komet USA). Using a sharp instrument, remove the plastic lining (Fig. 2B). After the adjustments, verify that the pressure molded record base does not rock and can be easily removed and reseated on the implant indexing device.
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