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ePaper created 2016-06-01, 10:23:49 | version 1.38.0
I 13implants 2_2016 C.E. article_ fixed and removable implant restorations I Figs. 21a, 21b_After seating the final lower implant overdenture, the maxillary provisional implant prosthesis was tried in to verify fit, form and function. Figs. 22a, 22b_The interocclusal relationship was verified with the final lower and provisional upper appliances in place. Figs. 23a, 23b_The metal housings of the overdenture caps were seated over the Locator attachments. Fig. 24_Quick Up cold-cure acrylic was used to pick up the metal housings in the overdenture and fill in the minor voids between the denture caps and recess wells of the prosthesis. Note: In many cases, the doctor elects to have the overdenture caps processed by the lab. Fig. 25_The black processing inserts were replaced with the appropriate retentive caps, which are color-coded according to strength. Fig. 2_ Patient with the final Locator overdenture and the upper provisional implant prosthesis in place. Fig. 27_The definitive maxillary restoration was milled from BruxZir Solid Zirconia, incorporating the slight adjustments that were made to the PMMA provisional appliance. estheticswereverified(Figs.21a,21b).Withbothap- pliances in place, the interocclusal relationship was checked(Figs.22a,22b).Minorocclusaladjustments were made directly to the maxillary provisional im- plant prosthesis, as PMMA is easily modified. Slight alterations were also made to the lower implant overdenture. Then, blockout shims and the retentive overdenture caps were seated over the Locator attachments (Figs. 23a, 23b). Quick Up self- cure material (VOCO America; Indian Land, S.C.) was added to the recess wells of the overdenture before seating the appliance over the metal housings. After letting the material set for approximately three minutes, the overdenture was removed, pick- ing up the denture caps in the prosthesis. The minor voids surrounding the denture caps were then filled with Quick Up light-cured pink composite (Fig. 24). The appropriate retentive inserts, which are avail- ableinavarietyofstrengthsdependingonthefunc- tional capabilities of the patient and the number of implants, were swapped into the metal housings (Fig. 25). The implant overdenture was reseated, providing excellent retention, stability and function for the patient. With the final mandibular restoration in place, the patient wore the provisional full-arch implant prosthesis for a trial period of two weeks (Fig. 26). This opportunity to wear the appliance during ac- tual day-to-day function instilled a high degree of confidence in the prosthetic design for the patient and doctor alike. Following patient approval, the provisional implant prosthesis was returned to the lab so it could serve as the blueprint for the final restoration and the minor adjustments made to the appliance could be included in the definitive prosthetic design. Fig. 21a Fig. 21b Fig. 22a Fig. 22b Fig. 23a Fig. 23b Fig. 24 Fig. 25 Fig. 26 Fig. 27