Fig. 10-52. The completed prosthesis.

Maxillary endosseous implant interventions 399

crown, and oxyphosphate of zinc cement was placed inside the anterior crown to seat the superstructure. The excess acrylic was removed while still soft, but the excess zinc cement was not removed until it hardened (Fig. 10-52) . An intraoral radiograph clearly shows the triplant pins avoiding the maxillary sinus (Fig. 10-53).

BILATERAL RESTORATIONS

Many patients lack posterior teeth on both sides of the arch yet retain a number of anterior teeth. For these patients, a fixed denture can be useful and successful. When enough bone exists posteriorly below the sinus floor, post type implants can be used. As long as there is enough bone flanking the sinus, it can be circumvented with a triplant. In those cases where the floor of the sinus has dropped to the resorbed alveolar crest, a blade implant can be inserted in the maxillary tuberosity distal to the most distal extent of the maxillary sinus.

In addition to the type of implant, other considerations apply. These will be explored in detail under the sample case presentations.

Case 7

Bilateral posterior restorations using triplants and templates

This patient was bilaterally edentulous (Fig. 10-54) . An alginate, or irreversible hydrocolloid, impression of the remaining unprepared anterior teeth and both edentulous areas of the maxillae was taken, as well as an opposing jaw alginate impression.

Fig. 10-53. A final intraoral periapical radiograph clearly reveals the circumvention of the sinus floor using the pin implants.

Fig. 10-54. The patient was bilaterally edentulous in the posterior region.