Implant Placement and Immediate Final Rehabilitation

As described above, this technique is used for stressfree postoperative delivery of the restoration. The way of achieving this will be discussed later, in connection with the delivery phase. The putty matrix was used to verify the space requirements during fabrication of the prosthesis. Care must always be taken to ensure that both the abutments and the metal base are located within the body of the reha- bilitation and that sufficient space remains for the teeth and resin base. In accordance with the process- ing instructions, the bonding bases and castable bar sleeves were placed on the implant analogs and mounted with the prosthetic screw. Using the lingual bite rim, the sleeves were adjusted to optimal length. This differs from when these components are used on a bar abutment, because in this procedures it means keeping the maximum length of the sleeve, extending up to the occlusal plane or, in the anterior segment, just behind the teeth. In doing so, the lin- gual bevel needs to be taken into consideration (Figs. 61 and 62). Subsequently, the framework was waxed up, including retention elements for the denture teeth but not the gingival portion. As a special fea- ture, lingual windows were cut into the bar sleeves. These were necessary to enable removal of any excess material from the prosthetic screws after intraoral bonding. The same could not be achieved from the occlusal plane, given the long chimney. After a final verification with bite rims and in the articula- tor, the base was cast in titanium (Figs. 63 to 65). EDI Case Studies 15 Fig. 62 Elements of a Camlog bar abut- ment. Bottom to top: implant analog, screwed-in bar abutment, bonding base, castable bar sleeve, prosthetic screw. Fig. 65 Cast titanium frame fitted to the master cast. Fig. 63 Finished wax-up of the metal base. Verification with a vestibular bite rim. Fig. 64 Finished wax-up of the metal base. Verification on the articulator. Fig. 61 Reduced bar sleeves. The lingual bite rim is placed for verification.