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implants international magazine of oral implantology

I case report 28 I implants3_2014 _The properties of PEEK PEEK is dimensionally stable up to a temperature ofabout152degreeCelsius,thematerialishighmelt- ing,about334degreeCelsius.PEEKisresistanttowa- ter and ionising radiation. Therefore, the physical properties do not change even during sterilisation at 170 to 180 degree moist/heat sterilization at 200 de- gree Celsius/one bar or during sterilisation using gamma radiation. The chemical consistency is very good. It only reacts with concentrated sulfuric acid (H2SO4).Therefore,theuseintheoralcavityissafeand the material has the CE mark for medical devices. The low specific mass, the elasticity similar to the one of bone,theabsenceofmetalsandthetoughness,com- bined with an almost non-existent material fatigue makesthematerialanidealpartnerinprostheticden- tistry and implantology. _Processing PEEK To process PEEK the so-called "semi-finished" base materialisneededwhichisproducedinseveralwaysof powdersorpelletsforlaterprocessing.Theseare: –Extrusion –Injectionmolding –Selectivelasersintering(SLStechnology) –CAD/CAM. CAD/CAMtechnology SincethematerialallowsprocessingusingCNCmills very well, the CAD/CAM technology is used to produce the finished parts. Elaborate individual work assign- ments of the dental technician in the form of scaffold modelling with subsequent individual polymerization canbeavoided. Tasksandobjectives The application of the double crown technique on implants will be described in the following. The prior mentioned advantages of the new material PEEK for dentistryshouldbeusedfordentalimplantsuperstruc- tures by prefabricating standardised parts. The men- tioned advantages of the double crown technique shouldremainandthedisadvantagesshouldbelargely avoidedorallowareconstructioninacosteffectiveway. Asystemisdescribedtocombinetheadvantagesof the already known traditional custom-made double crowns with individually milled primary parts with the advantages of double crowns with industrial prefabri- cation. Prefabricatedconepartsareusedwithdifferentan- gular deviations of the implant abutment (Fig. 7). For theseabutmentsperfectlyfittingPEEKcapsaremanu- facturedusingCAD/CAMtechnology. _Different indications and case documentations Case 1: Removable prosthesis on two implants—direct procedure The cone primaries can be parallelized in the pa- tient'smouthwithouttimeconsumingimpressiontak- ing and transfer to a model. Only an X-ray control recording to verify the abutment seating is useful. The previouslymadefullmandibulardenture(Figs.8a–c)is markedwithsiliconeattheimplantexitpointsaftertis- sueexposure.Then,theprosthesisismilled(Figs.9a–c) and adjusted in the patient’s mouth to the implant abutmentscoveredwiththePEEKcaps(Fig.10).Indo- ingso,nolatertensioncanarise.Usinganacrylicresin, Figs. 9a–c_Parallelisation of the primary parts in the mouth (a); X-ray control (b); grinding out the prosthesis for gluing the secondary parts (c). Fig. 10_PEEK secondary parts in site. Fig. 11_PEEK abutments polymerised in the prosthesis. Fig. 9c Fig. 11Fig. 10 Fig. 8c Fig. 9bFig. 9a

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