implants - international magazine of oral implantology

overview I I 29implants3_2013 ingareasofthejawwiththebonereplacementmate- rial Allograft made by Zimmer Dental. The implant in regio16wasinsertedatanangleof35degreesandfas- tenedbicortically.ThebiologicalmaterialAllograftwas stabilised with the addition of a Bio-Gide membrane madebyGeistlich. After extraction of the teeth in the lower jaw and smoothing of the jaw tissue, implants in regio 35 and 45weresetata35degreeangle,andimplantsinregio 32 and 42 were set at a 0 degree angle. All implants— intheupperandlowerjaw—wereprovidedwithabut- mentsandprostheticcaps. Priortosurgery,plastermodelshadbeenmade.Ad- ditionally,thedentallaboratorypreparedamock-upof thebitepattern,affixingsyntheticteethfortheupper andlowerjaws.Thisway,insteadoftakingaroughtra- ditional bite pattern with silicone and an individual tray after the operation, a more effective and innova- tive method was used. Right after surgery, the pros- thetic caps were powdered, and the prepared mock- upswithsyntheticteethwereaffixed. Advantages of this method: The base of the bite mock-upisusedasanindividualtraytoshowtheden- taltechnicianthepositionofthegums.Thisisveryim- portant for making the base of the bridge. Using the synthetic teeth, the dental technician can determine and document the relation of the jaws, bite height, chewing-, central- and laugh lines, as well as shape andlengthofteethformanufacturingthepermanent dentalprostheses. This method allows the lab technician to begin making a long-term temporary solution. At the same time, this also results in enormous savings of time for the doctor and the dental technician. For the patient, there is one important advantage: A feeling of addi- tional confidence. As in our case, the patient was able toseewhatherfutureprostheseswouldlooklike,mak- ingherfeelmoresecure. Conclusion The Fast & Fixed therapy concept represents an in- teresting new development which has established it- selfinthelastfewyearsasasolutionfortoothlessjaws. This method makes a firmly seated and biome- chanically supportive solution possible within 24 hours of implantation surgery. This was of special im- portance to our patient because she did not want re- movable dentures and preferred a fixed solution. Fin- ishinghersyntheticteeththefollowingdaywasmade possiblebythefactthatnoinfectionofthetissuewas presentonthedayofsurgery.Thejawbonewasintact and was still of good quality, so that primary stability could be warranted. What made the Fast & Fixed methodinterestinginthiscasewasthefactthatthere was only limited bone density available, so that only angled insertion of the implants could lead to the de- siredsuccess.Additionalsupportwasnecessaryinthe right upper jaw which was obtained with the use of bonereplacementmaterial. Bite impressions made prior to surgery saved the doctor additional time. The bite mock-ups are made exactly according to each patient’s individual needs, thereby making the dental technician’s work fast and efficient.Thepermanentprosthesesaremucheasierto makesincerelationofthejaws,biteheight,chewing-, central-andlaughlines,aswellasshapeandlengthof teeth had already been determined when making the mock-ups. Therefore, preoperative bite impressions and mock-ups represent an ideal addition to the Fast andFixedmethod._ Fig. 5_Stabilisation with BioGide Membrane. Figs. 6a & b_Finished implantation in the upper and lower jaw, with soft tissue sutured. Fig. 7_Post-op radiographs of the maxilla and mandible. Fig. 8_Post-op fixed bite mock-up of the maxilla and mandible, checking occlusion for balance. Fig. 9_Fixed long-term temporary solution with synthetic teeth made by Ivoclar, upper and lower jaw, 24 hours after surgery. Dr Regina Schindjalova Dentaprime-Zahnklinik St.Constantine Resort St.27,No.1 9006Varna,Bulgaria content@dentaprime.com _contact implants Fig. 5 Fig. 6a Fig. 6b Fig. 7 Fig. 8 Fig. 9