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CADCAM international magazine of digital dentistry

case report _ double crowns I Fig. 27_Impression to fix the superstructure. Figs. 28a & b_Final prosthesis. Figs. 29a & b_Clinical situation. Fig. 30_Clinical situation, FP 3 /4 acc. to C.E. Misch. Fig. 31_Peek parts on the stumps. Figs. 32a & b_Porcellain fused to metal bridge with PEEK secondaries before glueing together. Fig. 33_Finalised bridgework. I 29CAD/CAM 4_2014 Case4:Fixedprosthesisontwoimplantsandthreeunit bridges—screwingorcementingornoneofboth? This 77-year-old patient was already supplied with multiple implants and wanted the gap 23 to 25 to be filled with a fixed bridge (Fig. 30). Since it was a FP 3 option or indication according to C.E. Misch and hygiene deficits of patients had to be corrected with thehelpofaprofessionaldentalcleaning,inthiscase we decided to manufacture, similar to the previous case,aremovablebridgewhichwasneithercemented nor bolted. Theprocesswascorrespondingtothecasebefore. Thedifferencewasthatwewereusingporcelainfused tometal.Thebridgewasgluedinthemouthtothetwo PEEK caps (Figs. 31, 32a & b). Now, the patient has a verygoodchewingcomfort.Theprosthesiscanbere- moved from the prophylaxis assistant very well. The problem of a cemented bridge with the appropriate cement residues, a possibly too strong adhesion and a difficult retrieve possibility was avoided as well as thedisadvantagesofscrewing.Theuseofceramicve- neers fused to the secondary parts is possible and chipping avoided (Fig. 33). Case 5: Removable prosthesis on four implants and Locator® attachments—unsatisfiedpatient Thepatient,aged81years,hadsignificantproblems with the adhesion and fit of his lower jaw full prosthe- sisforyears.Becauseofcostconcernsabarortelescop- ing construction using electroplating was omitted. Al- though the initially applied two anterior implants with a simple ball connection device ensured a stabilization oftheprosthesis,therewerealwaysreturningpressure soresandpointsintheposteriorregionofthemandible Fig. 27 Fig. 28b Fig. 29a Fig. 29b Fig. 28a Fig. 30 Fig. 31 Fig. 32a Fig. 33Fig. 32b CAD0414_20-30_Vollmer 14.11.14 13:38 Seite 8 CAD0414_20-30_Vollmer 14.11.1413:38 Seite 8

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