408 Theories and techniques of oral implantology

Fig. 10-82. Posteriorly, teeth were absent.

Fig. 10-83. The remaining teeth were prepared for full coverage restorations.

Fig. 10-84. Spiral-post implants were placed in both posterior quadrants, avoiding the maxillary sinus.

erable to extraoral ones. Better still is the long cone paralleling technique using super-speed, intraoral films. From radiographic interpretation and the number and spread of the roots of the remaining abutment teeth, the types of implants to be used can be determined.

Because both posterior quadrants were edentulous and the remaining teeth in poor condition (Fig. 10-82), all the teeth were prepared (Fig. 10-83). Impressions for their castings were taken. For the fabrication of a temporary full arch splint, a full mouth elastic impression, a lower full jaw alginate impression, and an accurate wax interocclusal record of centric relation were also made.

At the second visit, the temporary acrylic splint was tried in the mouth. It fit accurately at the gingival marginal areas of the natural tooth abutments, as well as passively against the mucoperiosteal tissue

Fig. 10-85. Castings were made for the teeth and copings for the implants. All were picked up with a plaster index.

in the free-end saddles. The occlusion was articulated and balanced. The splint was then removed from the mouth and the gold castings tried for accuracy in fit and occlusion. An accurate full mouth, wax interocclusal record of centric relation with the castings in place was made, followed by a full mouth plaster index. The master stone model with the castings was then articulated and the castings soldered to each other.

At the beginning of the next visit, the soldered gold splint was tried in the mouth. When everything was satisfactory, the patient was ready for implant interventions.

Five spiral-post implants were inserted one by one (Fig. 10-84). The soldered gold castings were placed back on the anterior teeth, and interchange-able gold castings were placed over the implant shafts. A wax interocclusal record of centric relation