CAMLOG Special Issue VARIO SR Abutment

Case Report 11 | 2011 Fig. 9: Vario SR abutment in place. Because the implants show little divergence, straight abutments were used. INFORMATION ON PATIENT AND TREATMENT Fig. 6: Pop-in impression transfers in place. Note the use of closed-tray impression transfers, which are easier to use than open-tray transfers and are just as precise in the CAMLOG ® Implant Systemwhen the implants show little angulation towards each other. Fig. 7: Impression. Note that the colored caps have been removed. Fig. 8: Positive model with artificial gingiva and view of the parts used by the laboratory for making the bridge. Fig. 1: Preoperative radiologic exam: tomography. Fig. 2: Postoperative clinical view. The full-thickness flap with no incision for tension reduction was raised af- ter placing the three implants (3.8 x 11 in position 13, 4.3 x 11 in 14 and 16) and their healing screws (wide body, 4 mm high). The small pedicle flaps, technique derived from Palacci, provided for closure of the edges without tension, forming the future papillae. Fig. 3: Postoperative radiologic exam: periapical radio- graph. Initial situation Prosthesis steps Fig. 5: Clinical view after eight weeks at the time of impression-taking. Fig. 4: Clinical view after healing: note the irregular wounds corrected later by gingivoplasty with a cautery knife. The patient in very good health was an athlete almost 50 years old. He had been wearing a removable partial denture for more than five years to com- pensate for right maxillary tooth loss when he came to us for the first time. His request was clear, "I don't want to have an appliance anymore." His goal was more functional than cosmetic. The existing fixed prostheses cov- ering the sectors adjacent to the missing teeth were fully satisfactory to him both cosmetically and functionally. The edentulous space was large, and a bridge over teeth would have led to short-term failure. The treatment plan was therefore straightforward: replace 13.14.15.16 with a fixed prosthesis over implants. Clinical evaluation of the case showed a sufficient inter-arch space, good occlusion, and a significant amount of attached gingiva. The mucogingi- val junction was located far enough away from the middle of the crest. The mesiodistal distance was insufficient to replace the four missing teeth. We opted to make three teeth - one canine, one premolar, and one molar. The cone beam tomography showed significant residual bone volume, which gave us the best conditions for the implant insertion. It was there- fore not necessary to perform preimplant surgery to augment hard tissue or soft tissue. The following figures show the steps of the treatment.