Maxillary endosseous implant interventions 409

Fig. 10-86. The completed full arch fixed denture is cemented in with hard cement.

and a plaster index of the entire maxilla were again taken (Fig. 10-85) .

The master stone model was poured and both arches articulated on an articulator. The upper full arch splint was fabricated. Because this patient's bite was too strong for porcelain, an acrylic-and-gold veneer type bridge was chosen.

At the next visit, the temporary acrylic splint was carefully removed, and the completed prosthesis was tried (Fig. 10-86) . After checking articulation and gingival adaptation, the prosthesis was cemented in position with hard cement (Fig. 10-87) .

A lateral plate x-ray reveals the maxillary implants as well as the remaining abutment teeth and bridge (Fig. 10-88). Notice that two unilateral fixed partial dentures with posterior implants also exist in the mandible.

THE PARTIALLY EDENTULOUS MAXILLA

The major problems in planning a restoration for a partially edentulous maxilla are the anatomic configurations and the condition of the remaining teeth. The structure of the bone and the length of the gap between the teeth help determine the type, number, and most advantageous location of the implants. The state of the remaining teeth helps determine whether or not the bridgework will consist of one or more sections. The following cases illustrate some of the ways in which spiral-post implants and triplants have been used as abutments for restorations.

Case 11

A full arch splint for a partially edentulous maxilla using non–self-tapping vent-plants

Here vent-plants of an early design were used. These were too long between the apical ring and the

Fig. 10-87. The finished case.

Fig. 10-88. A lateral plate x-ray reveals lower as well as upper implants.

last thread, leaving the broadest part of the implant too close to the alveolar crest. They were non–selftapping, made of tantalum which is heavy—and almost entirely hand-fashioned. Because of too many adverse characteristics, these have been discarded in favor of the more successful, modern, self-tapping vent-plants. However, despite the flaws of these early