400 Theories and techniques of oral implantology

Fig. 10-55. The teeth were all prepared.

All of the remaining teeth were prepared (Fig. 10-55) and compound tube impressions and a wax interocclusal record of centric relation were taken.

Cold cure acrylic of the desired shade was then squeezed into the teeth impressions inside the alginate impression. The alginate impression was carefully positioned over the prepared teeth, which had been lubricated with Vaseline, using the posterior edentulous areas as guides for proper seating. The impression was held motionless in the patient's mouth for approximately 5 minutes, until the acrylic hardened, and then it was removed. The resulting acrylic splint was carefully trimmed, fitted, and adjusted along its gingival and occlusal margins and cemented in with one of the soft temporary cements.

At the next visit, gold copings were fitted over the abutment teeth (Fig. 10-56) . A wax interocclusal record of centric relation was made and a full mouth plaster index taken.

A full arch fixed denture was fabricated; in this case it was made of acrylic over gold. All the copings were soldered and processed with acrylic teeth. The scalloped template, which extended over the edentulous areas, began distal to the last abutment on each side of the arch (Fig. 10-57). Just behind the last natural abutment on each side was a vertical post. This bore the first crown in each bridge. The scalloped template continued distal to each post, ending where the last tooth in the bridge sat. The out-line, design, and contour of the scalloped areas were determined by the contour of denture teeth, which

Fig. 10-56. Gold castings to support acrylic teeth were fitted over the preparations.

Fig. 10-57. The prefabricated prosthesis included the processed acrylic teeth and the scalloped templates. (From Linkow, L. I.: Maxillary endosseous implants, Dent. Concepts 10 [1] :14-24, 1966.)

were placed on the master stone model before the template was made. The teeth should esthetically complement the anterior teeth of the arch. Because the template should always fit passively over the soft tissue, no "ditching" should be made on the master cast prior to the waxing of the template.

The prosthesis was then fitted in position over the prepared abutment teeth (Fig. 10-58), and all necessary gingival and occlusal adjustments were done. The adaptation of the template to the underlying soft tissue was also carefully evaluated for passive fit.