Implants

I 37implants1_2013 research_ Impression and registration I cept provided adaptability. Through waxing and casting, the height, diameter and an- gulations can be addressed in order to pro- vide a wide range of clinical solutions for problems associated with limited interoc- clusal distance, interproximal distance, im- plant angulations and related soft tissue responses.15 The customised implant abutments served as primary telescopes, and the electroformed copings served as second- ary telescopes in cases where a removable denture with telescopic crowns was used as the attachment. Electroformed gold copings are associated with several advantages, in conjunction with both removable and fixed restorations. The galvano-forming and elec- troforming process yielded a precisely-fitted secondary coping for the implant abutment with a gap of only 12–30μm. The gold elec- troformed coping saves space and is made of high-quality material.2-4 Using gold cop- ings for the impression allows for the ex- act transfer of the form, angulations and position of the inserted customised implant abutments. With the help of the milled mock-up, the future fit of the CAD/CAM fabricated framework can be evaluated and neces- sary changes in the shape of the restoration and occlusion can be made. Making these changes on the mock-up was easier and less time consuming than making them on the metal framework itself, and it was then possible to transfer them directly to the fi- nal framework. Furthermore, the mock-up almost “splinted” the electroformed gold copings during the impression, allowing for the exact transfer of the abutment position. At the same time, the vertical height and interocclusal relationship were recorded. The delivery of a milled temporary restora- tion permitted a slow and non-progressive loading of the implants, which then leads to bone remodeling.16 Abutments were left in place after mounting. Combined with the fabrication of a new cast, this further de- creased the risk of inaccuracies during the transfer process. _Conclusion The method described here can be used for fullarch restorations with both fixed and removable implant supported dentures. Ac- curate impressions can be accomplished and occlusion, vertical dimensions, as well as implant positions can be transferred while facilitating the full-arch restoration process. In addition, this technique resulted in a reduction of the required chair time. Disadvantages of this technique lie in the fact that the quality of laboratory techni- cian’s work meets higher demands than usual, and that the clinician also needs to acquire some additional skills. Further dis- advantages of this method include the need for a highly qualified technical lab and higher technical costs relative to those as- sociated with prefabricated titan implant abutments. To date, this method has not been applied in conjunction with immediate implant loading. However, dentists and patients have come to expect this level of rehabilita- tive accuracy, precision, long-term success and aesthetics._ Editorial note: A complete list of referenc- esisavailablefromthepublisher. implants Prof. Gregory-George Zafiropoulos Blaues Haus Sternstr. 61 40479 Düsseldorf, Germany zafiropoulos@prof-zafiropoulos.de www.prof-zafiropoulos.de _contact