418 Theories and techniques of oral implantology

Fig. 10-122. Occlusally, the acrylic cores should be cut short enough to allow room for full crown restorations.

Fig. 10-123. The superstructure is cemented over the template.

Fig. 10-124. The entire full arch denture is seen.

and the cores prepared and checked to avoid interference with occlusion (Fig. 10-122).

A rubber base impression of the posterior area with the prepared acrylic cores and the vertical gold post extending from the template was then taken with the necessary wax bite. Finally, at the next visit, the small unilateral fixed partial denture was cemented over the vertical gold post and acrylic cores (Fig. 10-123). It thus became an integral part of

Fig. 10-125. Intraoral radiographs of the vent-plants and triplant case are seen.

the full arch splint (Fig. 10-124). Intraoral radio-graphs show the implants in place (Fig. 10-125).

Case 14

A full arch restoration for long edentulous spans using the template technique

Whether or not a template is used to span the gaps between natural tooth abutments depends on a number of influencing factors: the firmness of the fibromucosa, the degree of support provided by the bone around the abutment teeth, the periodontal condition, conditions in the opposing arch, and the patient's habits, including bruxism and oral hygiene.

When abutment teeth are weak for any reason and screws or pin implants are to be used, the template should be included as part of the pros-thesis. When the fibromucosa is flabby and thick, it must be removed before a template is used. When triplants and, usually, internally threaded implants are used, a template is necessary. This is never necessary when using blade implants. Templates have been frequently criticized by periodontists as well as dentists practicing general dentistry, who claim that they irritate the soft tissues. Linkow has removed many fixed free-end saddles done by other dentists, some of which were in the mouth longer than 10 years. He has never seen any inflammatory reactions of the soft tissues. Isikovitz from Sweden has done hundreds of superplants with the same results.

On the first visit of this patient, the remaining teeth were prepared for full crown restorations and impressions for the castings were taken. Ideally, in maxillary cases, gold copings for the fabrication of full coverage acrylic restorations are preferred be-