366 Theories and techniques of oral implantology

bone. Such a case will now be presented. Only two teeth, the left first and second bicuspids, remained. A prefabricated full arch denture was processed in acrylic and gold (Fig. 9-101), and the patient wore it temporarily for 24 hours to test for comfort and pontic interferences on the soft tissue (Fig. 9-102). Areas where the pontics infringed on the soft tissues were trimmed accordingly.

The implants were placed in one by one (Fig. 9-103). In this case titanium vent-plants were combined with synthetic sapphire implants (Fig. 9-104). As each implant was inserted, the bridge was fitted over it and the corresponding pontic hollowed out. After all the implants were in the bone and the prosthesis properly fit, cold cure acrylic was added inside the pontics to get a closer adaptation of pontics to implants. The patient wore the bridge

Fig. 9-105. The bridge is cemented with oxyphosphate of zinc.

temporarily for a few more days to ensure that none of the pontics impinged on the underlying tissues. The prosthesis was then cemented with hard cement (Fig. 9-105). A Panorex clearly illustrates the implants and fixed full arch denture (Fig. 9-106).

Case 12

Full arch restoration for a partially edentulous mandible using internally-threaded vent-plants

Certain post type implants, including those of Jeanneret, Chercheve, Muratori, Benaim, and Linkow, have internally threaded hollow posts that accept small bolts. This is a good feature for several reasons:

1. The superstructure needs not be cemented; in-stead, it can be screwed into position.

2. The implants need not be parallel to each other, as they must be with solid shaft implants. This facilitates the operation.

3. Because the fixed prosthesis is screwed into, rather than cemented over, the shafts, the hollow-shafted implants need not extend more than 0.5 to 1 mm. out of the mucosa. Thus temporary splints need not necessarily be fabricated to help stabilize the implants and protect the tongue, cheeks, and lips from protruding shafts.

4. If an implant should have to be removed, the procedure is less complicated.

The patient used to illustrate the technique had only three remaining teeth in the mandible. These supported a removable partial denture (Fig. 9-107). The three remaining teeth were prepared for smooth-surfaced gold copings with interproximal extensions

Fig. 9-106. A postoperative Panorex reveals all five implants and the two teeth.