Maxillary endosseous implant interventions 387

Fig. 10-1. A veneer crown casting is fitted over the cuspid preparation, which will be the anterior abutment for the contemplated four-unit fixed partial denture.

bar. In this case, a four-unit fixed partial denture with scalloped template was the restoration. The abutments were the left cuspid and a single triplant.

On the first visit, the cuspid tooth—the most anterior abutment tooth   was prepared. A modeling compound tube impression of it was taken, as well as a wax bite and an opposing jaw impression. From this impression a gold veneer casting was fabricated.

On the second visit, the cuspid veneer casting was fitted and adjusted (Fig. 10-1). A wax interocclusal record of centric relation and a plaster index, including the cuspid casting and entire edentulous area, were taken. The cuspid on the master stone model acted as the anterior abutment for the fabrication of the scalloped template. Immediately distal to the cuspid casting, a wax vertical post was fashioned with a shoulder all around its gingival border, which continued interproximally as a shoulder and buccally or labially as either a shoulder, chamfer, or feather edge.

The template, which was attached to the distoproximal surface of the wax vertical post, was waxed in such a fashion that its buccolingual and inter-proximal contour took on a scalloped shape in order to follow the predetermined ridge lap of the teeth. The shape was predetermined by placing various sized acrylic denture teeth against the gingival surface of the master stone model until the proper sizes were determined.

The template was no thicker than a very thin sheet of green wax, and its buccal and lingual peripheral borders were rolled slightly so the template would not interfere with the soft tissues. The wax template was carefully removed from the master

Fig. 10-2. The scalloped template is soldered to the cuspid casting and the acrylic facing is processed to it. It is then fitted in the mouth.

Fig. 10-3. A, From an intraoral radiograph the locations of the holes in the template are determined. B, Hard cement is placed inside the cuspid crown and it is cemented into place.