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ePaper created 2014-08-26, 21:44:32 | version 1.30.01
I 23 case report _ full-arch restoration I CAD/CAM 3_2014 _Temporary bridge and immediate loading It was agreed with the patient that the implants would be immediately loaded, provided that good initial stability was obtained. The temporary remov- able prosthesis would be worn for a limited period. Fortunately, adequate stability was achieved, allow- ingforimmediateloading.Eachimplant(except#27) was torqued to 35 Ncm or more. On the same day, animpressionwasmadeusingthepick-uptechnique, with a previously prepared impression tray. First, thefinalstraightconicalabutmentswerehandtight- ened into the implants using a torque of 15 Ncm. They were intended to accommodate the screw- retained provisional and then the final screw- retained prosthesis. The Axiom PX implant system offers two major advantages: platform switching and indexing trilobe Morse taper connection. The latter greatly facilitates abutmentplacement.Atightstableconnectionguar- antees integrity of the soft tissue (Fig. 8). In the laboratory, the master model with the embedded analogue was used to fabricate a master plaster cast. A high-rigidity cobalt–chromium and resin temporary bridge was fabricated, tried in, and transferred to the patient’s mouth 48 hours after the implants had been placed. This provisional device would serve as an external fixator during osseo- integrationoftheimplants. A control radiograph was taken to confirm the passivefitoftheframework.Thetemporarybridgewas hand tightened to a torque of 10 Ncm. The occlusion was accurately adjusted (Figs. 7a-c). The patient wore the temporary bridge for six months. During that pe- riod, a number of parameters were evaluated, includ- ing occlusion, osseointegration status, oral hygiene, mastication,phonetics,aestheticsandlipsupport.The Fig. 8_Healing status at six months post-op. Fig. 9a_The impression. Fig. 9b_The interconnected pick-up transfer copings. Fig. 9c_The wax bite block. Fig. 9d_The master model. Fig. 10_A wax-up of the framework. Figs. 11a–d_CAD of the model. Figs. 12a–c_Machining from a titanium block. Fig. 11dFig. 11c Fig. 11bFig. 11a Fig. 12cFig. 12a Fig. 12b Fig. 10 CAD0314_20-25_Marcelat 22.08.14 14:22 Seite 4