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Implants

34 I I research_ Impression and registration implants1_2013 casting with a chromium cobalt (CrCo) alloy (for example, Ankatit, Anka Guss, Waldas- chaff, Germany, Fig. 6b). After casting, the customised implant abutments were grinded, polished and served as the basis for the fabrication of electroformed puregold copings with a thickness of 0.25 mm (AGC Galvanogold, Au > 99.9 per cent, Wieland, Fig. 6c).2-4 The framework was then constructed via CAD/ CAM. To ensure proper functioning of the framework, a plastic mock-up and a tempo- rary fixed denture (TFD) were milled (ZENO- PMMA, Wieland). The customised implant abutments, the electroformed copings, the mock-up and the TFD were delivered by the dental laboratory for the next clinical ses- sion. The abutments were transferred, posi- tioned on the implants and torqued to 35 Nm using a resin transfer key (pattern resin, GC; Figs 7a & b). From this point on, the cus- tomised abutments remained fixed in order to avoid any possible inaccuracies. The elec- troformed copings were placed on the im- plant abutments (Fig. 7c). The mock-up was placed over the electroformed copings and the occlusion was checked with the bite re- cords (Figs. 8a & b). A final impression with a polyether impression material (Impregum, 3M ESPE) was taken with electroformed copings. The mock-up was further set up and used for the fabrication of a new (final) master cast. After the impression was taken, the TFD was fixed on the implant abutments using temporary cement (TempBond, Kerr, Orange, CA). It was then left in place until the delivery of the final restoration (Fig 8c). The new master cast was articulated with the help of the gold copings and the mock- up. The metal framework was milled (here: Titanium Zenotec TI, Wieland, Fig. 9a). The veneering of the superstructure was made using a light-cured indirect ceramic poly- mer (Ceramage, SHOFU, Menlo Park, CA, Figs. 9a–d). The electroformed gold copings were fixed in the metal framework using a self-curing compomer cement (AGC Cem, Wieland, Fig 10). The above-described procedures can be also performed in cases in which a fixed denture was planned for the rehabilitation of the full-arch (Figs 11a&b, Figs 12a–c) and Fig. 6c Fig. 7a Fig. 7b Fig. 7c Fig. 8a Fig. 8b Fig. 8c Fig. 6c_Electroformed gold copings. Figs. 7a & b_The customized abutments are mounted on the implants using a transfer key. Fig. 7c_Electroformed gold copings in situ. Figs. 8a & b_Brial of the mock-up. Fig. 8c_Temporary fixed denture in situ