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ePaper created 2018-01-31, 10:01:59 | version 1.38.0
| industry report Fig. 18 Fig. 19 Fig. 20 Fig. 21 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. Insertion and aftercare Summary The bridge was fixed using the prosthetic copings (SKY uni.cone transverse prosthetic coping) and bolting in the practice. As this was carried out as three-point fix- ation, tilting or rotation of the dental prosthesis can be ruled out. Thanks to the slightly inclined position of the bolt screw, the prosthetic coping is “pressed” onto the abutment platform without showing a gap once it is tight- ened. This elegant type of fixation combines high-quality aesthetics with a tension-free position. The “screw chan- nels” are located in the palatine region of the cervical area, which does not lead to any aesthetic or functional impairments. Following final fitting, the functional, aes- thetic and periodontal hygiene factors were subjected to a final check and the patient was discharged from the practice with an aesthetic, fixed restoration (Figs. 19 & 20). The superstructure was designed in such a way as to ensure optimal hygiene was guaranteed. 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 philos- ophy is to combine the components in an optimal man- ner. This requires a high level of cooperation between the practice and laboratory, which can be experienced more intensively and effectively in the digital workflow. Various concepts are offered for the final prosthetic res- toration and the individual details are therefore taken into consideration. In order to rule out an aesthetically com- promising solution, in this case orthograde screwing of the dental prosthesis—screw channel emerging occlus- ally—was avoided. A normal bond was achieved in the region that was not visible by means of transverse bolt- ing. The access to the bolting, which was easily achieved, made it possible to easily remove the dental prosthesis in the practice. The patient was given comprehensive instructions in this regard. An important pre-requisite for the long-term success and therefore for a stable periodontal situation is aftercare in the practice. For the first year after treatment with an implant, in particular, a continuous, specific recall system is recommended. The patient had a consultation in the practice every three months. Once the superstruc- ture was removed, professional cleaning and disinfection of the components of the dental prosthesis bearing the implant were carried out. The peri-implant soft tissue re- mains exemplary to date (Fig. 21). contact Dr Jan Kielhorn Specialist in Oral Surgery Private practice Verrenberger Weg 15 74613 Öhringen Germany info@praxisklinik-kielhorn.de www.praxisklinik-kielhorn.de 30 CAD/CAM 1 2018