implants UK - the journal of oral implantology

I 21 dental tales_ gus’s tale I implants1_2011 Stage 2 Temporisation: The fixture head impression was poured and a resin (Pattern resin LS - GC) framework fab- ricated on six of the fixtures using temporary cylinders (Fig. 4). Teeth(HeraeusPremium-HeraeusKulzer)were set onto the framework for a tooth tryin (Figs . 5a-b). The set up was tried in and the tooth arrangementwascustomisedtoGus’ssatisfaction (Fig. 6). Back on the model, indices (Lab Putty - Coltene Whaledent) were fabricated of the tooth position from the tryin. The indices were used as a guide for the fabrication of the definitive teeth. The tryin was then processed in autopolymeris- ing resin (Palapress - Heraeus Kulzer) (Fig. 7a)and used as a fixed temporary to replace the denture (Fi.g 7b) and to load the fixtures (Fig. 7c). Stage 3 Definitive restoration: Definitive, cast to, gold copings with plastic chimneys were screwed in to the implant replicas on the master cast (Fig. 8a). A castable resin frame- work was then constructed to the copings (Pattern Resin LS - GC) (Fig. 8b). Using indices taken of the trial set up a full con- tour wax up was poured to the framework (Fig 8c). A beam framework with individual tooth prepara- tions was fabricated by cutting back the wax up (Fig 9a). This was sprued (Fig 9b), invested and cast in a beam gold alloy (Bio Degulor M - Degudent). The cast framework was checked back on the master cast (Fig 10a) and then tried in the mouth to confirm fit (Fig 10b). The metalwork with its tooth preparations was refined (Fig. 11a), sprayed with a photosensitive powder (Fig 11b) and then digitally scanned (Cerec In EOS - Sirona) (Fig. 11c). Virtual images captured by the scanner were used to design the copings to bemilledinZirconia(Figs.12a-c).Zirconiacopings were milled (Cerec in LAB - Sirona) (Figs. 13a-f) and sintered overnight (ZYrcomat - Vita) Fig. 14a-b). Once trimmed and heat treated ceramic (VM9 - Vita) was applied to the individual copings (Figs.15a-e). Except where screw holes are located under the crowns the rest of the crowns were definitively cemented to the framework (Panavia – Kurarary Co.) (Fig. 16). The removable teeth were then seated and the gingiva waxed up (Fig. 17). After the access teeth were Fig. 2c Fig. 3a Fig. 4 Fig. 3b Fig. 5a Fig. 5b