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today Chicago Midwinter Meeting Feb. 26

exhibitors16 Chicago Midwinter Meeting — February 26, 2015 By Michael McCracken, DDS, PhD, and Jonathan P. Ouellette, DMD n Fixed hybrid dentures have been used to successfully restore fully edentulouspatientsfordecades.Their durability, however, leaves room for improvement. The BruxZir® Full-Arch Implant Prosthesis (Glidewell Laboratories; Newport Beach, Calif.) provides a restorationthatismoredurableinthe long term, while sacrificing nothing when it comes to esthetics. Case report The patient is a 58-year-old male with no contraindications for implant treat- ment. The patient had a total of 11 BioHorizons® Internal Hex implants (BioHorizons; Birmingham, Ala.) placed, including six in the maxilla andfiveinthemandible(Figs.1,2).The implants integrated for more than six months, and the patient presented for restoration of his edentulous arches. First, preliminary impressions of the implants were made. After remov- ing the healing abutments, closed- tray impression copings were seated. The impressions were made in stock plastic trays, and the impression copings were placed back into the impressions before the case was sent off to the laboratory. The laboratory poured casts from the initial impressions and fabricated bite blocks and occlusal rims for the centricjawrelationship(CJR)records. Each bite block contained two screw- Using BruxZir to restore the edentulous arches Here in Chicago For more information on the BruxZir Full-Arch Implant Prosthesis, please stop by the Glidewell Laboratories booth, No. 4220. retained temporary cylinders that allowed the wax rims to be screwed down, producing a very accurate CJR. The contoured rims were returned to the laboratory with the initial casts. Upon receiving the wax rims and jaw relation records, the labora- tory and dentist decided the patient required four multi-unit abutments in the anterior maxilla to ensure the screw access openings were within theconfinesoftheplannedprosthesis. At the next appointment, the patient’s healing abutments were removed, and the multi-unit abut- mentsweretransferredtothepatient’s mouth and torqued into place. Later, wax setups were tried in and evalu- ated for proper esthetics, phonetics, contours,occlusionandtootharrange- ment. The implant verification jig (IVJ), which precisely captures the depth and angulation of the implants in the final impression, was seated and tight- ened into place. After bonding the individualsectionsoftheIVJtogether, a final impression was made. The lab produced a fixed provi- sional appliance using precise CAD/ CAM technology. The provisional implant prosthesis afforded the patient a trial period to evaluate the proposed restoration for esthetics and function (Fig. 3). The final restoration was fabri- cated using the CAD design that was confirmed during the provisional trial period. The final prostheses were delivered without complication, exhibiting excellent fit, occlusion and esthetics (Fig. 4). The patient was exceptionally pleased with the func- tion offered by this fixed restoration, which he should be able to enjoy for a great number of years given the extraordinary durability of BruxZir Solid Zirconia. 5 Fig. 1. (Photos/Provided by Glidewell Laboratories) 5 Fig. 2 5 Fig. 3 5 Fig. 4 Fig. 35

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