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ePaper created 2017-05-10, 16:12:25 | version 1.38.0
| case report restoration of the edentulous maxilla Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 19 Fig. 20 Fig. 21 Fig. 15: At this stage, the most suitable areas for positioning the retentive systems are identified, according to the aesthetics and functionality given by the teeth set-up. – Fig. 16: Side view scans. – Fig. 17: The vertical attachments are placed distally from the last implant in order to improve the prosthesis’ retention. – Fig. 18: Positioning of the distal attachment. – Fig. 19: Once positioned, the distal attachments from the tissues should be well evaluated; otherwise the cap and its housing may compress the soft tissues. In this phase, keeping the scan abutments in transparency also provides an opportunity to check the cuff height. – Fig. 20: Virtual bar. – Fig. 21: Buccal view of the virtual bar. and the gums had healed. The final phase also fol- lowed all the directions given to the patient about her experience with the temporary restoration. All this information is critical to improving the aes- thetics and the functional aspects in the final phase. For this reason, a new alginate impression was taken to produce an individual tray in order to produce an edentulous model and a preliminary registration rim for the mounting of the models in the articulator using a face bow. After the first phase was achieved, a teeth set-up restoring the aesthetics and the correct function was created (Fig. 5). Once these parameters were determined, the teeth set-up was duplicated us- ing the silicone masks with a transparent resin (Fig. 6). The replica was perforated to correspondence with the implants in order to take a definitive impression in the centric relationship and with the same vertical dimension of the teeth set-up (Figs. 7 & 8). After the production of the master model, a resin jig was created by screwing the transfers on the model and by connecting them with resin that was cut around each implant; the dentist reconnected it in the mouth, assuring the correct impression posi- tion of the implants. When the jig was returned to the laboratory, a small model was created with the new analogues; this is an important model for the verification of the passivity and the precision of the structures (Figs. 9 & 10). With the same model, the accuracy of the position of the analogues in the mas- ter model was verified. At this stage the models, the implants and the teeth set-up were scanned in order to have all the information to verify the available spaces, and the number and position of the implants; only now is it possible to correctly plan a suitable prosthetic project, according to the available spaces; this also means choosing the correct attachments that will guarantee a good retention without modi- 20 CAD/CAM 2 2017