Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2017-12-06, 12:03:50 | version 1.38.0
| industry Figs. 7 & 8: The drilling template and the pre-fabricated temporary restoration with palate for optimum positioning. Fig. 9: Inserted implants with the corresponding superstructures for the SKY fast & fixed concept. Fig. 10: Long-term temporary resto- ration with target fracture sites in front of the intraoral adhesion and lining. Fig. 11: Bridges screwed onto the Fig. 7 implants (long-term temporary restoration following removal of the palate) for immediate restoration. Fig. 8 Fig. 9 Fig. 10 Fig. 11 34 implants 4 2017 the slightly inclined position of the bolt screw, the prosthetic coping is “pressed” onto the abutment plat- form without showing a gap once it is tightened. The treatment team benefits from the transverse bonding of the dental prosthesis with the implants with excel- lent aesthetics and a complete lack of tension. Patient case The 48-year-old patient came for a consultation in the practice due to an unsatisfactory removable den- tal prosthesis in the maxilla. Teeth 11 to 23 were still present, but severely damaged periodontally. A fixed restoration was requested. The high mobility grade of the teeth would not permit a stable anchoring of a new dental prosthesis. Therefore, following a discus- sion with the patient, extraction of the teeth and im- mediate implant prosthetic restoration was planned in accordance with the SKY fast & fixed concept. Planning As a planning base, a situation model was initially produced (Fig. 2). This was digitalised in the laboratory scanner (D800, 3Shape) and an STL data set was cre- ated. In order to validate the implant positions, the two-dimensional X-ray image only yielded limited information about the available bone (Fig. 3). A three- dimensional image (DVT) was therefore compiled, without a scan template being required for this. Thanks to the allocation of space for the anatomical structures, a detailed analysis of the jaw was now possible. Using the planning software (coDiagnostiX, Dental Wings), six implants were planned in the local bone based on the visualisation of the anatomical structures and the digital set-up (ideal position of the prosthesis; Fig. 4). By angling the distal implants, anatomically vital structures were circumvented and augmentation measures avoided. The angle of the implants is between 30 and 45 de- grees for the SKY fast & fixed concept. In addition to the individual surgical components, special prosthetic su- perstructures are integrated in the complete concept. A drilling template for the navigated implant insertion and a temporary restoration were created from the planning software for the immediate restoration (Figs. 5 & 6). In order to guarantee accurate positioning in the mouth, both objects were designed with a palate, whereby the temporary dental prosthesis is produced with target fracture sites, in order to guarantee a pal- ate-free design of the screwed bridges (Figs. 7 & 8). Implantation and immediate restoration At the time of the surgical procedure, the existing teeth were extracted atraumatically and six implants (blueSKY, bredent medical) were inserted with the help of the drilling templates. The implants were in-