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ePaper created 2017-12-06, 12:03:50 | version 1.38.0
industry | Anchoring The “fixed” treatment option has become import- ant for edentulous jaws and jaws that are becoming edentulous. Many patients state that they are not sat- isfied with the classic removable total prosthesis; in particular, if they lose the last few teeth they still have. They want an aesthetic, functional implant prosthetic restoration. However, areas of limitation, such as sub- optimal anatomical circumstances, are often en- countered. In order to be able to avoid bone augmen- tation, measures where possible in these cases, as well as problematic implant positions and limited aesthet- ics, suitable implant prosthetic solutions are sought. The SKY fast & fixed concept is one of those. In principle, a distinction is made between screwed and cemented prostheses in fixed implant prosthesis. In an edentulous jaw, we generally prefer a screwed reconstruction. In contrast to cementing, the main benefit is the fact that the restoration can be removed from the implants without problems. For example, if an abutment were to loosen or a repair be required, the restoration can be carried out with ease. What is more, hygiene measures are simplified, which is an important aspect, particularly with regard to profes- sional implant aftercare. The treatment concept In the SKY fast & fixed therapy, the implants are in- serted in the local bone in such a way that they can be restored immediately after insertion with a fixed temporary bridge. Osseointegration is supported by means of primary interlocking. In order to be able to insert the implants into the jaw without augmentation measures where possible, meticulous preoperative in- vestigations and an implant component especially de- signed for use in this situation are pre- requisites. This objective can generally be achieved by means of an- gled insertion of the posterior implants. The immedi- ate temporary restoration is guaranteed by means of screwing onto the implants, resulting in stable inter- locking. The pre-fabricated interim restoration is made from plastic. Due to the relatively low elasticity mod- ule, the load application on the implants can be cush- ioned during the healing phase. Following successful osseointegration, several prosthetic configurations lead to the desired result. The primary requirement of the restoration is the tension-free fit on the implants. Transverse screwing Due to the type of screwing of the dental prosthe- sis, a choice can be made between two variants in the described concept. In addition to occlusal screwing, a bonding element is also offered for the transverse (horizontal) screwing. This offers an aesthetic benefit Fig. 4 Fig. 5 Fig. 6 Fig. 4: Three-dimensional planning of six implants, based on a DVT. Figs. 5 & 6: Digitalised situation model (STL): determining the drill template design. in many situations. Orthograde screwing—screw channel emerging occlusally, often especially means a compromising solution in the anterior region in terms of aesthetics. The seal of the screw channel in the visible region of the front teeth limits the dental technician with regard to the aesthetic design. Ade- quate alternatives include normal bonding elements in the region that is not visible. The SKY fast & fixed abutment with horizontal cir- cumferential groove is available for this and is restored using a pre-fabricated transverse screwed coping. This type of screwing involves bolting in the true sense of the word. The thread for the bolt screw is located in the bridge framework. The bolt screw and the cylindrical surfaces form a unit (Fig. 1). Fixation is carried out as three-point fixation, which prevents tilting. Thanks to implants 4 2017 33