Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2014-11-20, 16:14:55 | version 1.30.01
I 35 case report _ immediate restoration I CAD/CAM 4_2014 the cylinders were shortened to denture level, andtheirchannelswereclosedwithsilicone(Fig.8). The patient thus received a temporary immediate restoration in one treatment session. Radiographs showed an excellent fit of the abutments and cylin- ders and a good positioning of the implants (Fig. 9). Afterosseointegrationoftheimplants,teeth17and 27, which could not be preserved, were extracted. After eight weeks of healing, the temporary den- ture was removed and the Uni Abutments EV were exposed to prepare for the final impression (Fig. 10). For this procedure, Uni Abutments EV Pick-Ups were connectedtotheabutmentsandtheimpressionwas made using a customised impression tray (Fig. 11). When the impression material had set, the pins were unscrewed and the impression was removed. Uni Abutment EV Replicas were attached to the pick-ups in the impression to prepare the master model made from dental plaster stone (Fig. 12). A diagnostic wax-up was created on the model to be able to plan the exact location and dimension of the planned bar structure. The model and wax-up were sent to DENTSPLY Implants manufacturing center, where they were scanned, and the data was trans- ferredtotheATLANTISISUSsoftware.Usingthesoft- ware, an ATLANTIS ISUS Hybrid superstructure was designed (Fig. 13). After review and approval of this designbythedentistanddentaltechnician,theframe- work was milled from a solid block of cobalt-chrome in the DENTSPLY Implants manufacturing centre. Review of the precise fit was controlled and ver- ifiedinproductionaswellasreferringtothemaster model(Fig.14).Withthepreviouslycreatedwax-up, the final restoration was completed. The ATLANTIS ISUS Hybrid superstructure was installed to the abutments with a torque of 15 Ncm (Fig. 15). The screw channels were subsequently sealed with composite.Thecontactareaofthedenturewiththe maxillary mucosa was designed in a slightly convex form that prevents air from escaping, avoids pho- netic problems and food impaction, and allows for good oral and denture hygiene (Fig. 16). The control radiographs showed the marginal bone to be at the level of the implant shoulder and also an excellent fit of the prosthetic restoration (Fig. 17). Aesthetics and function were ideally recreated and the upper lipwaswellsupportedbytheprosthesis.Thepatient was very satisfied with the result (Figs. 18a & b). _Conclusion Restoration of the edentulous maxilla with an implant-supported fixed restoration presents great challenges for the treating dentists. The present case describes how an excellent prosthetic restoration can be created both in terms of function and aesthetics using the ASTRA TECH Implant System EV and an ATLANTISISUSpatient-specificimplantsuperstructure._ Editorial note: A complete list of references is available fromthepublisher. Fig. 17_Peri-apical radiograph showing the perfect fit of the restoration. Figs. 18a & b_Final aesthetic outcome. Dr Fernando Rojas-Vizcaya, DDS,MS Department of Prosthodontics University of North Carolina, Chapel Hill,NC,USA Director of the Mediterranean Prosthodontic Institute, Castellon,Spain CAD/CAM_about the author Fig. 17 Fig. 18bFig. 18a CAD0414_32-35_Rojas 14.11.14 13:39 Seite 4 CAD0414_32-35_Rojas 14.11.1413:39 Seite 4