implants - international magazine of oral implantology

I research Figs. 8a & b_Brial of the mock-up. Fig. 8c_Temporary fixed denture in situ. Figs. 9a-d_Final telescopic crown retained implant denture, palatal; (Fig. 9a), anterior teeth (Fig. 9b), right side (Fig. 9c), left side (Fig. 9d). Fig. 10_Placement of the electroformed copings into the frame. denture, a DentDu could be fabricated and further used as described above (Figs. 13a-c). Porcelain is a possible material for veneering of fixed-denture frameworks. If the angulation of the implants does not allow for taking impressions in the above-described way and an open-tray impression is preferable, fenestrations can be fabricated into the DentDu (Fig. 14). _Discussion The reconstruction of the fully edentulous arch with implant-retained dentures necessitates thor- ough planning and a precise and passive fit of the suprastructure. A previous study demonstrated that a passive fit between the implant superstructure and the underlying abutments is essential for the long- term success of the implant prosthesis.5 To achieve a passive fit, an accurate positioning of the implant replicas in the master cast must be assured. The im- pression technique and the splinting of the implant copingsarefactorswhichmaycontributetoerrorsin the final positioning of the implant analogs, thus leading to inaccuracies in the fit of the final super- structure.5-10 Furthermore,theangulationorproxim- ity of the implants may inhibit proper seating of the impressioncopingsand/orcaps,whichmayalsohave adetrimentaleffectontheregistrationoftheimplant position.11 The precise recording of the maxillo-mandibular, e.g. interocclusal, relationship is a prerequisite for achieving proper occlusion and a successful treat- ment outcome.1,10 The initially delivered denture al- lowedforthecorrectionoftheinterocclusalrelation- ship, tooth shape and color and angulations during the entire healing period. In this way, the patient was abletoacclimatizetothefunctionandestheticsofthe denture.Inthemethoddescribedinthisreport,anac- curate impression and recording of the full denture wasachievedbyusingaduplicateasacustomtrayfor the impression. Therefore, it was not necessary to re- peatallthestepsusuallyneededforrecordingthein- terocclusal relationship, e.g. wax-up, etc., at the time of the fabrication of the final restoration. Ifanopen-trayimpressionispreferred,onlyminor changes to the procedure are necessary. This method is based on a previous publication.12 In cases such as this, it is advisable to fabricate two DentDus. The im- pressioncanbetakenbythefirstDentDu;thesecond DentDu is used for the remaining steps. Customized abutments are applied instead of a bar, galvano cop- ings allow a precise transfer coping, and secondary telescopes as well as different technologies are em- ployed for the transfer of implant positions and for the construction of the superstructure. Customized implant abutments allows for better angulations and shape, for improved occlusal force 16 I implants3_2012 Fig. 8b Fig. 8cFig. 8a Fig. 9a Fig. 9b Fig. 9c Fig. 10Fig. 9d