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ePaper created 2018-01-31, 10:01:59 | version 1.38.0
industry report | possible in these cases, as well as problematic implant positions and limited aesthetics, suitable implant pros- thetic 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 recon- struction. 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 mea- sures are simplified, which is an important aspect, partic- ularly with regard to professional 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 tempo- rary 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 investigations and an implant component especially designed for use in this situation are pre- requisites. This objective can gen- erally be achieved by means of angled insertion of the posterior implants. The immediate temporary restoration is guaranteed by means of screwing onto the implants, resulting in stable interlocking. The pre-fabricated interim restoration is made from plastic. Due to the relatively low elasticity module, the load application on the implants can be cushioned during the healing phase. Following successful osseointegration, several prosthetic configu- rations lead to the desired result. The primary require- ment of the restoration is the tension-free fit on the im- plants. 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 (hori- zontal) screwing. This offers an aesthetic benefit in many situations. Orthograde screwing—screw channel emerg- ing 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. Adequate alternatives include normal bonding elements in the region that is not visible. 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. 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 the slightly in- clined position of the bolt screw, the prosthetic coping is “pressed” onto the abutment platform without show- ing a gap once it is tightened. The treatment team bene- fits from the transverse bonding of the dental prosthesis with the implants with excellent aesthetics and a com- plete lack of tension. Patient case The SKY fast & fixed abutment with horizontal circum- ferential groove is available for this and is restored using a pre-fabricated transverse screwed coping. This type of The 48-year-old patient came for a consultation in the practice due to an unsatisfactory removable dental pros- thesis in the maxilla. Teeth 11 to 23 were still present, but CAD/CAM 1 2018 27