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implants - international magazine of oral implantology

case report I I 27implants4_2012 plant abutments of optimal angulation and shape, and also facilitated the fabrication of an aesthetically pleasing implant-supported restoration. In the case presented here, the customised abutmentswerenotremovedaftermountingand torqueing until the final restoration was fitted and placed. Thus, the position of the abutments remained unchanged, eliminating or minimising errors that might occur during repeated attach- mentoftheabutments(forvarioustestfittingsof the restoration) to the implants and master cast. Thefixationoftheelectroformedgoldcopingsaf- ter and not before veneering eliminates addi- tional errors which may occur due to the influ- enceoftheveneeringcompositeduringpolymer- ization. In the present report, the patient wished forafixedrestorationofthemaxilla.Basedonthe planning model, he accepted a telescopic con- struction. In the case of a fixed implant-based denture, the crown-to-root ratio would have beenunfavourablehadnaturalteethbeenusedto support the restoration. To date, no long-term studies have docu- mented the influence of the crown-to-root ratio on the success rate of implants fully. Researchers have postulated that an increase in crown-to- tooth and crown-to-implant ratios will cause an increase in the magnitude of non-axial forces transmitted to the tooth or implant. This, in turn, could cause increased vulnerability of either teethorimplantabutmentsandleadtothelossof supporting bone around the implants (Gomez- Polo et al. 2010). The existing data does not allow any definitive conclusions to be drawn. In the present case, the patient’s hard and soft tissues could have been augmented surgically to provide an aesthetically and functionally accept- able rehabilitation using fixed restorations. Cases such as this raise the question of whether it is preferable to exhaust all surgical possibilities or to pursue the path of least resistance by combin- ing classic prosthetic experience with modern techniques and materials. In many circum- stances, the latter is a better and safer treatment alternative. For this reason, oral surgeons and pe- riodontists should consider the prosthodontic treatment plan extremely carefully before select- ing any course of action._ Editorial note: A complete list of references is available fromthepublisher. Fig. 21 Fig. 22 Prof Dr Dr habil Gregory-George Zafiropoulos Sternstr.61,40479 Düsseldorf,Germany zafiropoulos@prof-zafiropoulos.de www.prof-zafiropoulos.de _contact implants Fig. 18_Final restoration. Frontal view. Fig. 19_Final restoration. Right view. Fig. 20_Final restoration. Left view. Fig. 21_Final restoration. Palatal view. Fig. 22_Final restoration. Orthopantomogram. Fig. 18 Fig. 19 Fig. 20