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ePaper created 2014-11-20, 16:14:55 | version 1.30.01
case report _ double crowns I I 25CAD/CAM 4_2014 Fig. 12_Implants after insertion. Fig. 13_Secondary conical parts parallelised and fixed. Fig. 14_Try-in of the PEEK secondary parts. Figs. 15a & b_Impression fixing the PEEK parts and bite registration in one step. Figs. 16a & b_Wax up of the teeth and try-in of the full denture. Fig. 17_Tertiary framework try-in and glueing in the patients mouth for passive fit. Figs. 18a–c_Repositioning of the metal frame and check of the passive fit. the PEEK caps are then glued in the patient's denture directly(Fig.11).Thismethodenablesaso-called"pas- sive fit" of the removable prosthesis. Due to the good adaptationofthePEEKmaterialtotheprimariesasuc- tion effect develops in addition to the friction of the parts. The primary parts can—if necessary—be sand- blastedandthusroughenedtoincreasethefrictionef- fect. Nevertheless, this is not required in most cases if there are sufficient parallel surfaces. In the present case, in spite of an in the posterior area severely at- rophic mandible, one has been able to achieve a very goodstabilisationoftheremovableprosthesiswithout having the effect of a rotation around the linking axis oftheimplants. Case2:Removableprosthesisonfourimplants— half-directprocedure Thefemale79-year-oldedentulouspatienthadre- ceived a new lower denture about one year ago. She was very unhappy all the time, until she had been in- formed by an acquaintance about the possibility of dental implantation. After appropriate education and measurement of the bone volume, four implants were inserted in the anterior mandible (Fig. 12) to provide a supply with prefabricated titanium primary telescopic crownsandPEEKsecondarycrowns. Afterthreemonthsofhealing,thetitaniumcopings were then parallelised in the patient’s mouth (Fig.13). ThePEEKcapswereadjustedtotheprimarycrowns(Fig. 14) and both bite registration and functional impres- sion were made in one step procedure (Fig. 15). In the meantime,theexistingprosthesisofthepatientwasal- ready supplied with two PEEK caps and a soft relining, so that the primary abutments no longer had to be re- moved. In the next session, the wax try (Figs. 16a & b) and the tertiary framework try-in was done. After the wax try-in,thesecondaryPEEKcrownswereplacedbackin themouthagainandthepremademodelcastingrein- forcementwastriedin.Sincethefitwasverygood,ac- cording to the passive-fit method, the gluing of the PEEK abutments with the tertiary structure in the pa- tient's mouth was made with a dual curing material (Fig.17). Fig. 15a Fig. 16aFig. 15b Fig. 12 Fig. 14Fig. 13 Fig. 16b Fig. 18aFig. 17 CAD0414_20-30_Vollmer 14.11.14 13:37 Seite 5 CAD0414_20-30_Vollmer 14.11.1413:37 Seite 5