Maxillary endosseous implant interventions 419

Fig. 10-126. Gold castings are designed to support acrylic teeth.

Fig. 10-127. A wax interocclusal record of centric relation and a plaster index are taken.

cause gold is lightweight, a considerable help when few abutment teeth are present. A wax bite and opposing jaw impression were taken, and the master model was poured in stone and articulated.

On the second visit, the castings were fitted over the remaining natural tooth abutments (Fig. 10-126). An accurate wax interocclusal record of centric relation and a plaster index of the entire arch were taken (Fig. 10-127). The template was waxed, cast, and soldered to the copings (Fig. 10-128). Acrylic full crown restorations were processed over the copings (Fig. 10-129).

At the next visit, the substructure was tried in the mouth (Fig. 10-130). Radiographs of the edentulous bone area along the entire region of the tern-

Fig. 10-128. A scalloped template that encompasses the large edentulous area is soldered to the remaining copings.

Fig. 10-129. Acrylic teeth are processed to the crown copings.

plate were taken. 'tie template acted as a landmark for angulating the pins to avoid the nasal vestibulum and maxillary sinus. From the radiography, the series of holes for the triplants was determined; these holes were then drilled into the template outside the mouth.

The template was fixed in the mouth by cementing the acrylic-over-gold crowns over the tooth abutments with hard cement. The triplant pins were driven through the template (Fig. 10-131) and their ends notched and shortened to the proper inter-maxillary occlusal lengths.

The ends were built up with acrylic cores, and the hardened cores were prepared for full crown restorations (Fig. 10-132). A rubber base impression