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ePaper created 2016-08-01, 17:31:37 | version 1.38.0
July-August 2016 | No. 4, Vol. 6Published in Dubai www.dental-tribune.me IPS e.max® PRESS MULTI THE WORLD’S FIRST POLYCHROMATIC PRESS INGOT • Monolithic LS2 restorations showing a lifelike shade progression • Exceptional combination of strength, esthetics and efficiency • For crowns, veneers and hybrid abutment crowns • Coordinated with high-precision Programat press furnaces • Maximum cost effectiveness in the press technique • • • all ceramic all you need www.ivoclarvivadent.com Ivoclar Vivadent AG Bendererstrasse 2 | 9494 Schaan | Liechtenstein Tel.: +423 235 35 35 | Fax: +423 235 33 60 LIFELIKE ESTHETICS – EFFICIENTLY PRESSED Screw-retained bridges: pressed-over or veneered? The implant restoration for the edentulous jaw By Cristian Petri, Romania Either – or? Why not both? If the in- dividual layering technique is com- bined with the press technique, es- theticrestorationscanbefabricated in an efficient way. When producing implant-support- ed bridges, the occlusal screw reten- tion is an increasingly important factor. Due to the restorative pos- sibilities provided by the material zirconium oxide and the develop- ment of CAD/CAM systems, this type of restoration is already very common.Occlusallyscrew-retained bridges allow the dentist to access the connection point between the superstructure and the implant. This enables for example, the peri- implant situation or the fit of the abutment to be checked. As a result, we can predict good results over a longer period of time. In addition, the process of inserting the resto- ration is made easier, and regular monitoring of the superstructure is possible. Quite often, a cemented restoration is chosen when the screw channel opening for securing the abutment to the implant is located on the vestibular side – where it is visible. There is however, a way of creating a screw-retained restoration with- out compromising the esthetics. Patient case After the insertion of eight im- plants in the edentulous maxilla and a four-month healing period, the practice sent us the implant im- pressions. The implant axes were quite strongly divergent from one another (Fig. 1). We were asked to produce a zirconium oxide bridge. Thedentistalsowantedtobeableto removetherestorationifnecessary. Based on these requirements, there was only one type of screw-retained implant restoration we could make. After casting the model and set- ting the intermaxillary relation, the wax-up was produced. This wax-up served as a guide for the subsequent steps. A silicone matrix was made according to the wax-up. This gives an accurate idea of how much space is avail- able for the abutments, the frame- work and the veneers (Fig. 2). In an implant-supported restoration in Fig.1:Implantmodel.Thedivergingimplantsintheanteriorregionwere ideallyalignedusing the“no-Hex”abutments. Fig.4a:Themilledzirconiumoxideframework Fig.5:Thewax-upwascheckedin themouthand transferredinto the laboratorycompositeSRNexco. Fig.4b:Theopeningfor thescrewwascut witha threadcutter. Fig.6:Applyingmechanicalretention to theprostheticgingiva Fig. 2: A silicone matrix of the wax-up was used to check the amount of spaceavailablefor theframeworkandveneers. Fig. 3: Close-up view of the implant abutments. Angled “no-Hex”abut- ment in theanteriorregionand titaniumbasesin theposteriorregion. ÿPage 1 Tel.: +4232353535 | Fax: +4232353360