CAD/CAM - international magazine of digital dentistry

research _ impression and registration I I 31CAD/CAM 1_2013 Figs. 9a–d_Final telescopic crown retained implant denture, palatal; (a), anterior teeth (b), right side (c), left side (d). Fig. 10_Placement of the electroformed copings into the frame. Figs. 11a & b_A case of fixed implant retained denture for the maxilla full-arch rehabilitation: trial of the mock-up (a) and the milled temporary fixed denture is placed on the abutments (b). steps usually needed for recording the interoc- clusal relationship, e.g. wax-up, etc., at the time of the fabrication of the final restoration. If an open-tray impression is preferred, only mi- nor changes to the procedure are necessary. This methodisbasedonapreviouspublication.12 Incases suchasthis,itisadvisabletofabricatetwoDentDus. The impression can be taken by the first DentDu; the second DentDu is used for the remaining steps. Customized abutments are applied instead of a bar, galvanocopingsallowaprecisetransfercoping,and secondary telescopes as well as different technolo- gies are employed for the transfer of implant posi- tionsandfortheconstructionofthesuperstructure. Customized implant abutments allows for bet- ter angulations and shape, for improved occlusal force transmission from the crown to the implant and the bone, and also for facilitating the fabrica- tion of an esthetically pleasing implant-supported denture. Ways in which abutment design con- tributes to improved esthetics include changes in the location of the crown and changes in the di- mension and/or form of the restorative platform. Additionally, features of the abutment design contribute to the health and dimensional stability of the soft tissue. Current attempts to objectively define implant-restoration esthetics have focused on periimplant mucosal parameters.13,14 The intro- duction of the UCLA abutment provided a custom solution for implant restorations. This direct-to- implantrestorationconceptprovidedadaptability. Through waxing and casting, the height, diameter and angulations can be addressed in order to pro- videawiderangeofclinicalsolutionsforproblems associated with limited interocclusal distance, interproximal distance, implant angulations and related soft tissue responses.15 The customized implant abutments served as primarytelescopes,andtheelectroformedcopings servedassecondarytelescopesincaseswhereare- movable denture with telescopic crowns was used astheattachment.Electroformedgoldcopingsare associated with several advantages, in conjunc- tion with both removable and fixed restorations. The galvano-forming and electroforming process yielded a precisely-fitted secondary coping for the implant abutment with a gap of only 12–30 µm. The gold electroformed coping saves space and is made of high-quality material.2-4 Using gold copings for the impression allows for the exact transfer of the form, angulations and position of the inserted customized implant abutments. With the help of the milled mock-up, the future fit of the CAD/CAM fabricated framework can be evaluated and necessary changes in the shape of Fig. 9a Fig. 9b Fig. 9c Fig. 10Fig. 9d Fig. 11bFig. 11a