5. Restorative Phase

The Printed Try-In™

Full ArchA ROE invention, the Printed Try-in is the perfect prototype when working toward a full arch monolithic, final restoration.  This tooth-colored appliance (with a pink gingiva option), gives the patient the test-drive prosthetic needed to confirm the final.

Designed generally from the iJIG, the RAPID Appliance, or sometimes a screw-down tooth set-up, Doctors will receive this appliance and follow the usage instructions below. With this approved prosthetic, ROE will fabricate the final restoration, or by request, for an additional full fee, fabricate another Printed Try-In.

With the full CHROME GuidedSMILE package, one Printed-Try-In prototype is included when ordering the full package. We know you’ll love this product for restoring full arch patients.

Printed Try-In

Printed Try-In Workflow

Workflow Steps Instructions Images
Step 1 One-Screw (Sheffield) Test

Seat the Printed Try-In placing one screw in the distal most implant on one side and ensure a passive, no-rock seat. Repeat on the other side. If there is rocking, remove a cylinder from the Printed Try-In and pick-up, or section the temp and lute, like a verification jig, until all sections are passive and there is no rock. If no rock is detected, go to next step.
Step 2 Capture x-rays to ensure temp cylinders and abutments are engaged and fully seated.
Step 3 Equilibrate and adjust thoroughly. Adjust until the bite and VDO are exact. Adjust for esthetic and functional satisfaction.
Step 4 If it is a double arch patient, seat both appliances for the bite.
Step 5 Verify that the tissue adaptation is ideal. If not, either remove the prosthesis and digitally scan the tissue, or add some tray adhesive to the intaglio of the prosthesis and take a reline impression using medium body PVS.
Step 6
Check for proper lip support and phonetics.

To understand how to diagnose and correct phonetic issues refer to ROE’s ROE's Full Arch Case Speech Complications for the patient test phrases and how to mitigate identified speech complications.
Step 7 Photograph full-face, full-smile clearly showing what needs changed esthetically. Include opposing model.
Step 8
Send all records to ROE Dental Laboratory. Submit your records directly into your patient case via the ROE online portal

Next, ROE will fabricate the final prosthesis and send it back to you.

Printed Try-In Checklist

Quality Review Steps Issue Resolution
Check passivity with the
one-screw Sheffield test
If not passive, confirm if tissue pressure is the cause. If the tissue is the cause, then adjust the prothesis until a full and passive fit is achieved.

If lack of passivity is not tissue-related, ensure the MUA’s are torqued, then, if needed, section the Printed Try-In, screw down, and lute the pieces together. Return the luted prototype to ROE, equilibrated with a new bite registration, and a new Printed Try-In will be fabricated.
Verify the arch is fully equilibrated Conduct a full prothesis equilibration and capture a bi-lateral bite if needed.
Confirm tooth shade is correct Discuss with the patient the acceptance of the provided tooth shade. If not acceptable conduct an additional tooth shade tab confirmation and add to the Rx.
Confirm patient acceptance of esthetics Modify the prosthesis with additive composite and/or reductive adjustment as needed. Send new full-face, full-smile photographs, plus close-up smiling photographs to share any visible modifications if they require further digital changes.
Confirm tissue adaptation is acceptable (no gaps or excessive pressure) Ensure the fit and feel on the tissue is final, as this will be difficult to change in zirconia. Adjust the pressure as deemed necessary and perform a wash impression to share voids with the lab. A new Printed Try-In is always available to test the changes.
Conduct speech complication test
See ROE's Full Arch Case Speech Complications for the patient test phrases and how to mitigate identified speech complications.

Speech Complications Guide

Patient Test Phrase Target Sounds Mouth Position How to Address
“Dentition” D-N-T Tongue to hard palate Thin out the lingual area behind the teeth, while leaving a minimum of 3-4mm of material for strength. If needed, change abutment angles to move the screw access hole(s) closer to the teeth.
“Lolly” L Tongue to lingual of anterior teeth Anterior teeth are either placed too far facially or too far lingually. Too far facially: Add acrylic to the lingual of the teeth, then adjust. Too far lingually: Add acrylic to the facials of the teeth, then adjust.
“Thirty-three” TH Tongue between upper and lower anterior teeth Check the freeway space. There should be a min. of 2–3mm between max. intercuspation and the rest position. If there is not enough freeway space (too much VDO) grind the occlusals of posterior teeth on either/both arches to provide more freeway space and reduce VDO. Anterior teeth may need to be adjusted. If anterior teeth are not long enough, add composite to incisal edges.
“Mississippi” S-Z Tongue between upper and lower anterior teeth If space exists between the appliance and tissue, flowable composite can be injected into open spaces. If the upper and lower come into heavy contact, adjust incisal length of the upper/lower anterior teeth. Maxillary or mandibular antierior teeth may be too short. Lengthen with flowable composite until the “S” sound is corrected.
“Shoelace” SH Tongue to posterior teeth Posterior arch form is too narrow or there is too much VDO. Grind the lingual flange areas to make room for the tongue. If necessary, grind linguals of posterior teeth to make more room for the tongue. Consider creating a slight overjet, or cross-bite, on the mandible to make more room for the tongue. In many cases, the patient will have to adapt.
“Fifty-five” F-V Upper incisors to lower lip Maxillary anterior teeth that are set too high, or too low. Reduce the incisal length with a bur or lengthen by adding composite to the incisal edges of the teeth. Reaching with the lower lip to find contact with the upper incisal edges is a telltale sign of a problem. The jaw will move forward to allow the lower lip to find the incisal edges of the upper. Add length to the upper incisal edges until the “F-V” sounds are distinct.
“Bump” B-M-P Lip to lip Close the patient’s vertical dimension of occlusion, which will increase freeway space. If anterior teeth too far forward, bring teeth lingually to allow space for normal lip function.

7 Days

Lab Working Time

The Ultimate CHROME GuidedSMILE Guide

This ebook is your ultimate guide to CHROME GuidedSMILE.

This 90 page ebook:

  • Highlights the benefits of a fully integrated metal surgical guided system.
  • Over 200 images exploring every part of the CHROME GuidedSMILE process.
  • Links to 25+ videos offering over 8 hours of CHROME GuidedSMILE information and Instruction.

Videos

Perfect the Prototype for Perfect Full Arch

Perfect the Prototype for Perfect Full Arch
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ROE’s Printed Try-In

ROE's new Printed Try-In
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Printed Try-In

Printed Try-In
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From RAPID Appliance to Try-In

CHROME GuidedSMILE Prosthesis Workflow: From RAPID Appliance to Try-In, to Final Prosthetic
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Additional Information

Review our Full Arch Fixed Offerings

TLZ-IB TLZ-IB NobelProcera® Ultra Nano Traditional Hybrid
with Ti substructure
Application All patient types • Extra strength needed
• Less than 9-10mm space
• All, except heavy bruxers
• Does not use metal copings
• Must use Nobel-compatible multi-unit abutments
• All, except heavy bruxers
• Light weight
• To match existing hybrid
• Low bruxing clenching patients
Substructure Full Zirconia Titanium DOCERAM Nacera Pearl Zirconia Trilor Titanium bar
Materials • Full zirconia
• MiYO liquid porcelain
• Titanium cylinders
• Full zirconia
• MiYO liquid porcelain
• Titanium substructure
• DOCERAM Nacera Pearl Zirconia
• MiYO liquid porcelain
• Crystal Ultra teeth with Trilor Bar
Denture teeth
• Processed acrylic
• Titanium bar
Process • Submit flask or duplicate prosthetic
• Prototype Try-in
• Final
• Submit flask or duplicate prosthetic
• Prototype Try-in
• Final
• Submit flask or duplicate prosthetic
• Prototype Try-in
• Final
• Submit flask or duplicate prosthetic
• Prototype Try-in
• Final
• Custom Tray
• Bite block fit jig
• Set-up
• Set-up on bar
• Final
Prosthetic Design FP3/FP2/FP1 FP3 FP3/FP2/FP1 FP3 FP3
Minimum Vertical space 12mm 10mm 10mm 15mm 17mm
No. of Patient Visits 3 to 6 3 to 6 3 to 6 3 to 6 5 to 7
Quality of Esthetics ★★★★★ ★★★★ ★★★★★ ★★★★★ ★★★★
Wear ★★★★★ ★★★★★ ★★★★★ ★★★★ ★★★
Price $$$$ $$$$$ $$$$ $$$$ $$$$

Temporary Prostehtic ADA Codes

  • D5820 – Interim partial denture (temporary bridge)
  • D5810 – Complete denture, mandibular
  • D5840 – Removable unilateral partial denture (one piece)
  • D5860 – Removable unilateral partial denture (two pieces)
  • D5940 – Removable prosthodontic retainer
  • D5931 – Recement fixed partial denture

External Resources