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ePaper created 2017-08-25, 17:58:13 | version 1.38.0
| case report digital technology in fixed implant prosthodontics Fig. 17 Fig. 18 Fig. 19 Fig. 20 Fig. 21 Fig. 17: The maxillary arch restoration with occlusal and interproximal zirconia. (Fig. 7). Following impression taking, the Implant Replicas EV were assembled to the Implant Pick-Ups EV in the impression (Figs. 8 & 9). Fig. 18: Facial view revealing natural looking restorations in place on both teeth and implants. Fig. 19: A lateral view displaying healthy peri-implant and gingival tissues. Fig. 20: Radiographs of implants in the molar, premolar and lateral positions, along with the remaining natural dentition. Fig. 21: The patient’s smile following maxillary arch reconstruction of her remaining natural teeth and implants. 14 CAD/CAM 3 2017 After the final impression, the master cast was scanned. A fully anatomical digital wax-up was merged over the master cast and uploaded. Atlantis abutments were designed using the Atlantis VAD software (Fig. 10). Atlantis abutments were machined and scanned, and a final digital wax-up was performed (Fig. 11). The corresponding colour-coded abutment screws were included (Fig. 12). Full CAD/CAM PMMA provisional restorations were manufactured and assembled with the Atlantis abutments. The distal angulation of the molar implants is shown in Figure 13. A healthy and clean implant sulcus was evident at all of the sites to be restored (Fig. 14). The Atlantis abutments were delivered, installed, and tightened to 25 Ncm with the provisional restorations to assist in shaping the implant sulci (Fig. 15). Following a one- month provisionalisation period, the patient was scheduled for delivery of the final restorations (Fig. 16). The restorative design called for all interproximal and occlusal contacts to incorporate high-strength zirconia. A digital cutback of precisely 0.8 mm was used for the veneering porcelain in the areas where stresses are low and aesthetic demands are high. Treatment of this patient utilised digital processes and multiple merged data sets to make planning and treatment more accurate and efficient. In addition, it enabled the creation of fixed dental restorations that are supported by dental implants and natural teeth. Figures 17 to 21 show the clinical and radiographic views of the final restorations and the highly aes- thetic outcome._ Thank you to Debra Wasky, Dental Technician. Dentsply Sirona Implants products used: Astra Tech Implant System, Atlantis, Simplant. contact Dr David Guichet Prosthodontist, Private Practice Orange, CA, USA drdavid@guichetdental.com