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implants0112

I case report Fig.13_Occlusalviewofthemaster castinthelaboratory:aStraumann prostheticplanningkittoselect appropriatelyangledabutments toillustratetheparallelism. Fig.14_Lateralviewofthemastercast: optimalparallelismoftheabutments. Fig.15_Lateralview:bridge frameworkwax-up. Fig.16_Lateralview:angledsynOcta abutmentseatedinthemouthand torquedto35Ncm. Fig.17_Palatalview:finalrestoration seatedinthemastercast. Fig.18_Lateralview:finalrestoration seatedinthemouthinmaximum intercuspation. Fig.19_Occlusalview:finalrestoration seatedinthemouth,outcome correspondstothecastplan. Fig.20_Radiographoftheoutcome: insertionofthefinalrestorationinthe mouth,reimplantationintheright mandible. in diameter) in the place of teeth #25 and 26 (Figs. 4 & 5). The surgical procedure was done as planned through the extraction of tooth #24 with a non- traumatic tooth removal technique. No damage to thesurroundingalveolarridgeoccurred,andtheim- mediate placement of a long implant (Tapered Ef- fect;12mminlength,4.1mmindiameter)intheex- tractionsitefollowed.Thesecondandthirdimplants (Standard Plus; 8 mm in length, 4.1 mm in diameter, witharegularneck)wereinsertedusingabone-con- densation technique. The third implant was tilted distallyinordertogainmaximumbonecontactwith the implant surface—the limited alveolar bone heighthelpsavoidperforationofthesinusfloor.The prime stability of the implants was confirmed and theflapswererepositionedaccordingtoanon-sub- merged protocol. Furthermore, a post-operative panoramic radiograph was taken as planned (Figs. 6–10).Thepatientcamebackfortheprostheticstage afteralongvacationinJanuary2009.First,theperi- implant mucosa was assessed and determined to be healthy,withnobleedingonprobingaroundtheim- plant. Percussion of the implants indicated well-in- tegrated and stable implants. It was therefore de- cided to take a definitive impression for the final restoration, which was then made using snap-on impression caps. After the impression and the mas- ter cast were ready, a prosthetic planning kit (Strau- mann) was used to select suitable abutments and confirmtheparallelism.Two15°abutmentsandone 20° abutment from the synOcta implant system (Straumann) were selected (Figs. 11–14). The metal framework was constructed and tried in, and the X-ray revealed good marginal adaptation. The framework was then returned to the laboratory for ceramic application. Then angled synOcta abut- ments were seated in the mouth and torqued to 35 Ncm. The final bridge restoration was adjusted and verified in the mouth. Lastly, temporary cemen- tation was done (Figs. 15–20)._ 16 I implants1_2012 Fig. 17 Fig. 18 Fig. 14 Fig. 15 Fig. 16 Fig. 13 Fig. 20Fig. 19 Dr Maen Aburas DrAburas Dental Center LLC Room 401,Doha Center Building, Al Maktoum Road,Deira,Dubai UAE,P.O Box 11048 Dr Ralf Gutwald Hugstetter Str.55 79106 Freiburg/Breisgau Germany ralf.gutwald@uniklinik-freiburg.de _contact implants