Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-08-25, 17:58:13 | version 1.38.0
| industry report metal-free restorations Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 19 Fig. 20 Fig. 12: Cranial view of the completed prosthesis. Fig. 13: Completed prosthesis in the plaster model. Fig. 14: Insertion of four abutments in the implant shafts. Flexural rigidity and compression strength of TRINIA are high despite the minimal CAD/CAM processing time. TRINIA can be processed extraorally as well as intraorally. Its wearing comfort is excellent thanks to its light weight. (Fig. 18). The crown-implant ratio of 1 : 1 does not apply to the short Bicon implants anymore.9–12 Figure 19 shows the panoramic radiograph and figure 20 the clinical image from the follow-up examination 51 months later. Fig. 15: Tapping the abutments Case presentations in the prosthesis. Fig. 16: Final tapping of the abutments, resulting in cold shut. Fig. 17: Panoramic view with inserted abutments and prosthesis. Fig. 18: Lateral cephalometric radiography. Fig. 19: Panoramic view at the control after 51 months. Fig. 20: Intraoral image of the mandibular prosthesis after 51 months. 34 CAD/CAM 3 2017 The cases described in the following represent only a small portion of the possibilities for this ma- terial. Figure 9 shows a panoramic radiograph of a 59-year-old female patient with extreme mandibu- lar atrophy class VI according to Cawood and How- ell7 after the insertion of four 4.0 x 5.0 mm short Bicon implants. After an integration time of three months, the appropriate model can be prepared after exposure and dental imprint (Fig. 10). Then, the ten- piece prosthesis can be manufactured applying the CAD/CAM method (Figs. 11–13). The corresponding implant shafts are found by means of the abutment temporarily fixed with Vaseline in the prosthesis (Fig. 14) and then the abutments are tapped via the prosthesis (Fig. 15). Then, the individual abutments are tapped again to fix them in the implants (Fig. 16). Because the abutment is end-tapered by 1.5 degrees towards the inner shaft, so-called cold welding hap- pens.8 The panoramic radiograph after the insertion of the cemented bridge illustrates the crown- implant ratio (CIR) of more than 5 : 1 (Fig. 17) and the lateral cephalometric radiography shows pseudo- progenia due to the severely atrophic maxilla The 59-year-old female patient presented in the following also suffers from distinct mandibular atro- phy class VI7 (Fig. 21). In that case, the four 4.0 x 5.0 mm short Bicon implants were tilted too far in the labial direction (Fig. 22), so that the prosthesis could be fixed only by means of screwed abutments to be placed in front of the mandibular anterior teeth. This resulted in very long cantilever segments on the distal side of the posterior implants. Despite the extremely heavy load of the TRINIA material, it did not break yet even after 64 months of wearing (Figs. 23 & 24). With our first ten patients with mandibular atro- phy class VI7, we measured a ratio of 4.3 : 1 from bridge span to implant span for 40 short 4.0 x 5.0 mm Bicon implants (Fig. 25).12 With 16 patients treated for atrophic mandibles class VI7 wearing four 4.0 x 5.0 mm short Bicon implants, we have lost one implant in the observation period of up to 5.6 years. This corresponds to a survival rate of 98.4 per cent. The patient had lost the left middle implant seven days after the initial treatment, which correlates to implant loss due to lacking osseointegration. Since then, she has been putting the load on the remain- ing three implants of her prosthesis for 47 months.