Page 34 - DP Vol 20 No 4 HR

IMPLANT DENTISTRY SECTION

copings were splinted using dental floss,
over which pattern resin was applied to
maintain the rigidity of the assembly
(Figures 9 and 10). This is done to ensure
no movement of the open tray impression
copings during the final impression, after
which rubber base material was used for
the final impression. If any movement is
noticed in the copings, redo everything
before considering that the lab could fix it
Fig 7-8: Multiunit abutments placed over the Fig 8 or that it wouldn’t matter.
implants Once the impression is taken, models are
poured with the respective analogues, and
multi-units are screwed over them. The
lab then scans the models with a desktop
scanner to design the prosthesis using the
EXOCAD software. Since the interarch
distance in this case is around 13 mm per
arch, we decided to go for an FP1 type
prosthesis (Figure 11). The upper and
lower arch prosthesis and occlusion were
designed in the same software (Figures 12,
Fig 9-10: Impression copings splinted using Fig 10 13, and 14). The jaw relation taken before
dental floss and pattern resin starting the procedure was used as a guide.
The lab then milled a PMMA temporary,
which was attached to the temporary
cylinders in the lab. The temporary
cylinders with the milled PMMA fit over
the multi-unit abutments. The entire
prosthesis was finally screwed into the
patient’s mouth (Figure 15).
Minor occlusal corrections were made
intraorally, and the occlusal slopes were
kept as shallow as possible. Instructions
were given to the patient to maintain a semi-
solid diet, especially for 4 to 5 weeks. After
allowing for osseointegration for about
3 months and verifying all the implants
radiographically, final impressions were
made.

PROSTHETIC PROCEDURE
Fig 11: FP1 type prosthesis planned Once the bite is stable over the milled PMMA
and the implants have osseointegrated,
osteotomies. Implants used were Neodent (Bredent). RFA values above 70 were and the patient is accustomed to the new
Aqua Helix (Figure 6). After achieving the considered suitable for immediate loading. bite, we record this bite with the bite
desired primary stability and evaluating the registration paste. The PMMA that the
ISQ values, which were above 70 for most of Temporization Phase patient is wearing is used to fast-track the
the implants, we decided to immediately load Multi-unit abutments were placed over the procedure for the final impression, wherein
the implants. implants and torqued (Figures 7 and 8). The the lab places the analogues in the intaglio
multi-units guaranteed an absolutely passive surface of the PMMA and pours the model.
Resonance Frequency Analysis fitting of the full-arch prosthesis and were not Additionally, the PMMA is scanned,
Resonance frequency analysis (RFA) helps unscrewed until final prosthesis delivery. Open providing all the information about the
measure the stability of the implants. The tray impression copings were screwed over occlusion, vertical dimension, jaw relation,
measuring device used was the PENGUIN the multi-unit abutments. All the impression etc. We did not have to take a jaw relation

34 Dental Practice I July-August 2024 I Vol 20 No 4