380 Theories and techniques of oral implantology

Fig. 9-148. A lateral oblique radiograph showing the position of the implants.

Fig. 9-149. A posteroanterior roentgenogram clearly shows the two bifid implants, the vent-plant, and the superstructure attachment.

ment inside the hollow splint was necessary. If the splint was not adjusted until all of the implants were set, the splint probably would never have fit properly and might have broken during the crude adjustments.

Cold cure acrylic was added inside the holes, and the splint was then placed over all of the implants. It was quickly removed and replaced about every 20 seconds or so and finally allowed to harden outside the mouth. It was then carefully trimmed and polished. Vaseline (or any antibiotic salve) was placed inside the holes   no cement of any kind should be used--and the temporary splint was set

Fig. 9-150. The edentulous mandible.

Fig. 9-151. A prefabricated temporary acrylic splint.

over the implants (Fig. 9-154). At this point the splint was not secured in the mouth and could easily be removed.

During the same visit, impressions for the final prosthesis were taken. This can be done by either of two methods. By one method interchangeable gold copings are slipped over the protruding shafts (Fig. 9-155) and a wax interocclusal record of centric relation is made and a plaster index taken (Fig. 9-156). The full arch fixed denture is then processed from the master model using the double casting technique, thereby utilizing the gold copings. The copings ntay also be used merely as transfer copings. In this latter procedure, duplicate implant shafts are placed inside the gold copings while they are still in the plaster index (Fig. 9-157). When the master stone model is poured, allowed to harden, and then separated from the plaster index, the copings are removed from the duplicate shafts. The shafts are then coated with three layers of lacquer, and then the full arch