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ePaper created 2017-01-25, 09:48:20 | version 1.38.0
1_2017 20 cast poured from the surgical template, with the implant replica on-site. Non-engaging titanium temporary abutments were connected at the implant or abutment level. The provisional res- toration was placed in the mouth and assessed for passive fit around the abutments. If any ten- sion was detected, more space was provided by adjusting the provisional restoration. Once the prosthesis had been completely seated, a pre- liminary occlusal adjustment was performed. Using a disposable syringe filled with a cold-cure acrylic resin, the abutments were then connect- ed to the temporary restoration by injecting the resin into the space between the abutments and the framework, having the patient close into occlusion. When the cold-cure acrylic res- in had fully set, the provisional restoration was unscrewed from the mouth. The restoration was then refined, polished and screwed into the pa- tient’s mouth approximately 2–3 h later. A final check of the occlusion and of the interproximal spaces was then performed. The screw access holes were closed with PTFE and temporary fill- ing material. Periapical radiographs of all of the implants were then obtained. All of the patients received postoperative instructions and pre- scriptions. In addition, an oral antiseptic and soft brushing were recommended for the first two weeks. Patients were recalled for clinical (Figs. 5a & b) and radiographic (Figs. 6a–c) examination and oral hygiene checks at two and four weeks, three, six and 12 months, and then yearly up to five years after implant placement. On average, the provisional fixed restorations were removed after six months and replaced with titanium or zirconia CAD/CAM screw-retained prostheses, with acrylic or ceramic esthetic material. _Outcomes The primary outcomes were implant and prosthetic survival and success rates assessed 15 days after prosthesis delivery and then yearly up to five years after surgery, according to Pa- Figs. 5a & b_Clinical situation after implant treatment at five years of follow-up. (a) Frontal view. (b) Lateral view. Figs. 4a & b_Implant planning with teeth still in place. (a) Occlusal view. (b) Cross-sectional image. expert article _ chirurgia guidata Fig. 4a Fig. 4b Fig. 5a Fig. 5b