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ePaper created 2016-10-04, 09:33:57 | version 1.38.0
full mouth restoration case report | 33 CAD/CAM 3 2016 In the same session, the apparatus was modified and rebased on healing screws so that the pa- tient did not find himself without an appliance (denture). The same will apply to the maxillary prosthesis. Validation key for the maxillary impression Inordertoensurethereliabilityofthemaxillaryim- pression a validation key must be made in plaster. This comprises a normal sized plate made of plaster with low shrinkage characteristics and which is not too hard (e.g. ‘Snow White’). This is then trans- screwed by each implant in the mouth. If it does not break, it means that the model used for making it is reliable. Articulator mounting A practical and reliable method for mounting on the articulator is the use of temporary appliances (dentures). In fact, once the impressions have been taken and the working models have been prepared, the appliances are positioned on implant replicas of the models. By placing both appliances in intercuspal relation, it is easy to obtain the patient’s occlusion. There are many benefits: it saves time as it is no longer necessary to make occlusion wax rims, and potential sources of errors are eliminated during the registration of the waxes. In order not to deprive the patient of both his/her dentures, this stage should ideally be performed in the dental surgery. If the teeth of thedenturesaretooworn,itispreferabletotakean inter-cuspal silicone bite to facilitate interlinking the two devices at the time of placement on the articulator. Preparation It is essential for the dentist to take impressions of temporary appliances. The models that are created from these impressions are also mounted on the articulator so that the working model and the study model are interchangeable on the articulator. If the appliances are suitable from a functional and aesthetic perspective, they can be faithfully reproduced. In this case, as the patient’s current prostheses could be improved aesthetically, we de- cided to create two aesthetic assemblies on a resin base(Fig.1).Theupperassemblywastrans-screwed at the level of the two posterior implants and in an anterior position to give the model stability. For the same reasons, the bottom is wedged on six implant pillars. As soon as the aesthetic assemblies are validated at afunctionallevel(occlusalrelationofbotharcades, DVO, phonetic, etc) and at an aesthetic level (length and projection in the sagittal direction of the anterior tooth region of the upper jaw, laugh line, any animation, etc), they become the basis for the laboratory technician’s work. In other words, these ceramic frameworks must be designed on these Fig. 6: Cr-Co framework —Laser microfusion before scraping and finishing. Fig. 7: View of the intrados and the smoothness of the entire framework. Fig. 8: Adjustment accuracy of the mandibular framework. Figs. 9 & 10: Cr-Co framework machined before scraping and finishing. Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 32016