398 Theories and techniques of oral implantology

where the triplant was contemplated, and the bridge removed for drilling holes to accommodate the pins. The bridge was then cemented in position with hard cement, which was chipped away when set.

One by one the pins were carefully driven through the template and fibromucosa and into the bone (Fig. 10-43). The pins were x-rayed for proper angulation in circumventing the maxillary sinus. They were fused together and to the vertical mushroom heads of the template with acrylic. The hardened acrylic cores were prepared for full crown restorations (Fig. 10-44).

The superstructure was tried in position (Fig. 10-45) and, after all necessary adjustments, cemented over the template (Fig. 10-46). A final lateral plate radiograph shows the triplant and template (Fig. 10-47).

Case 6

A full arch porcelain-baked-to-metal bridge for a unilaterally edentulous posterior arch using a template and triplant

The patient's remaining teeth were prepared for full coverage (Fig. 10-48) . The restoration included the full arch porcelain-baked-to-metal bridge with a posterior scalloped template and a two-unit super-structure (Fig. 10-49).

The prosthesis was tried in the mouth (Fig. 10-50) and removed for the drilling of holes in the template for the pins. The prosthesis was returned to the mouth and cemented with oxyphosphate of zinc cement over the prepared abutment teeth. The pin implants were then carefully drilled through the holes in the template and into the bone. All excess length of the pins protruding into the oral cavity was removed (Fig. 10-51). The pins were fastened with acrylic to form a core, which was then prepared. A soft mix of acrylic was placed inside the posterior

Fig. 10-49. The completed porcelain-baked-to-metal full arch denture with its scalloped template and superstructure is prefabricated prior to insertion of the implants.

Fig. 10-50. The prosthesis is fitted into position.

Fig. 10-48. All of the remaining teeth are prepared for full coverage restorations.

Fig. 10-51. After the holes are made through the template, the prosthesis is cemented over the prepared teeth. The pin implants are then properly angulated through the template and into the bone.