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| industry Fig. 18 Fig. 19 Fig. 21 Fig. 20 Fig. 22 Fig. 18: CAD/CAM-manufactured framework before the try-in in the mouth: the transverse bolting in the cervical-palatine area is easily recognisable. Fig. 19: The final restoration is fixed to the implants by means of transverse bolting. Fig. 20: Final X-ray image. The posterior implants were positioned obliquely in the local bone in accordance with the SKY fast & fixed concept. Fig. 21: Wonderfully healed soft tissue on recall (continuous hygiene phase). Fig. 22: The final restoration is fixed to the implants by means of transverse bolting. multiple-layer veneers (high-impact PMMA compos- ite) and the light- curing composites support the simple manufacture and the individual, aesthetic characterisation. In order to achieve efficient pro- gress, the cushioning properties against chewing pressure of the composite are combined, which are important to consider, particularly in implant prostheses. Insertion and aftercare The bridge was fixed using the prosthetic copings (SKY uni.cone transverse prosthetic coping) and bolt- ing in the practice. As this was carried out as three- point fixation, tilting or rotation of the dental prosthe- sis can be ruled out. Thanks to the slightly inclined position of the bolt screw, the prosthetic coping is “pressed” onto the abutment platform without show- ing a gap once it is tightened. This elegant type of fix- ation combines high-quality aesthetics with a ten- sion-free position. The “screw channels” are located in the palatine region of the cervical area, which does not lead to any aesthetic or functional impairments. Fol- lowing final fitting, the functional, aesthetic and peri- odontal hygiene factors were subjected to a final check and the patient was discharged from the prac- tice with an aesthetic, fixed restoration (Figs. 19 & 20). The superstructure was designed in such a way as to ensure optimal hygiene was guaranteed. removed, professional cleaning and disinfection of the components of the dental prosthesis bearing the implant were carried out. The peri-implant soft tissue remains exemplary to date (Fig. 21). Summary The success of a total concept such as SKY fast & fixed is based on a coherent procedure. From the surgi- cal components to the prosthetic materials—the phi- losophy is to combine the components in an optimal manner. This requires a high level of cooperation be- tween the practice and laboratory, which can be experienced more intensively and effectively in the digital workflow. Various concepts are offered for the final prosthetic restoration and the individual details are therefore taken into consideration. In order to rule out an aesthetically compromising solution, in this case orthograde screwing of the dental prosthesis—screw channel emerging occlusally—was avoided. A normal bond was achieved in the region that was not visible by means of transverse bolting. The access to the bolting, which was easily achieved, made it possible to easily remove the dental prosthesis in the practice._ contact The patient was given comprehensive instructions in this regard. An important pre-requisite for the long-term success and therefore for a stable peri- odontal situation is aftercare in the practice. For the first year after treatment with an implant, in particu- lar, a continuous, specific recall system is recom- mended. The patient had a consultation in the prac- tice every three months. Once the superstructure was Jan Kielhorn Specialist in Oral Surgery Private practice Verrenberger Weg 15 74613 Öhringen, Germany info@praxisklinik-kielhorn.de www.praxisklinik-kielhorn.de Author details 36 implants 4 2017