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Implants

42 I I industry report _ Full arch rehabilitation implants1_2013 then applied to the cervical area of the teeth on the mask to achieve an aesthetic strati- fication of the gingival denture resin. The facial occlusal mask and the resin bar were then repositioned on the model to confirm the appropriateness of their contours relative to each other and particularly to the cervical gingival area of the intended teeth. If neces- sary, the resin bar may be modified by add- ing wax or by reducing it with a bur. Prior to its being sprayed and digitally scanned, the space between the resin bar and the ridge area between the pencil lines on the model is filled with a putty material, so that the milled framework can be in contact with the soft tissue of the edentulous ridge (Fig 6). Afterthemodelwiththemilledabutments and the resin bar were separately sprayed and scanned, the Trinia fibre resin bar was digitally designed on the computer with a minimum thickness of 7.0mm throughout, an abutment clearance of 30 microns for cement and with a maximum cantilever ex- tension of 21.0mm. If necessary, the milled Trinia framework may have been judiciously reduced manually. After cleaning the milled Trinia framework with alcohol, it was placed onto the milled abutmentstoevaluateand,ifnecessary,mod- ify the marginal adaptation of the framework to the abutments and to the alveolar ridge of the model. The ridge side of the framework should be convex without any concavities. Additionally, the Trinia framework was used to confirm both the path of insertion of the prosthesis and the sequence of insertion of the milled abutments on the model. After the sequence and path of insertion were con- firmed, the facial, occlusal and lingual masks wererepositionedonthemodelandattached together with cyanoacrylate glue (Fig 7). A thin mix of denture resin was poured into the silicone flask through the anterior cutaway or aperture in the lingual mask. Fi- nal polymerisation was achieved while the silicone flask and models were under hot water, with an air pressure of three bars. Af- ter polymerisation, the Trinia prosthesis was removed from its silicone flask, then fin- ished and polished in a conventional manner. Clinically, after the removal of the temporary abutments from the implant wells, at least two milled abutments were incompletely in- serted into the prosthesis. If necessary, they were stabilised with an application of Vase- line, prior to their being transported to the mouth and inserted into the well of their im- plant (Fig 8). The loosely fitting abutment fa- cilitated its insertion into the well of the im- plant (Fig 9). Once the abutment was initially seated, the prosthesis was removed for the definitiveseatingbytappingdirectlyontothe titanium abutment. This seating process was continueduntilalloftheabutmentswerede- finitively seated (Figs 10 to 12). Alternatively, an abutment could have been initially be loosely seated in the well of theimplant,priortotheprosthesisbeingused to orient and seat the abutment in the well of the implant. Final or temporary cementation was achieved by first applying Vaseline over the ridge area of the prosthesis to facilitate the removal of any extraneous cement. Only a minimum of cement was applied to the boresintheTriniaframeworkbeforeinserting the prosthesis in the mouth. The extraneous cement was blown away with an application of air under the prosthesis. The occlusion was evaluated and adjusted (Figs. 13 & 14)._ Editorialnote:Acompletelist of references isavailablefromthepublisher. implants Prof. Mauro Marincola Via dei Gracchi, 285 I-00192 Roma, Italy mmarincola@gmail.com _contact Fig 13 Fig 14