450 Theories and techniques of oral implantology

Fig. 10-239. A temporary anterior acrylic splint was fitted with soft cement.

Fig. 10-240. The completed acrylic-over-gold full arch fixed denture.

The template was cemented over the three protruding vent-plant posts with hard cement (Fig. 10-235). The pin implants were slowly drilled through the predetermined holes, avoiding the antrum and avoiding perforation of the buccal and palatal plates of bone (Fig. 10-236) . The pins were fastened together and to the mushroom-shaped protrusions with acrylic and locked to the gold template. The acrylic cores were then trimmed and pre-pared for crown restorations (Fig. 10-237) .

An elastic impression of the entire maxilla was taken (Fig. 10-238), as well as a final wax inter-occlusal record of centric relation. A temporary anterior acrylic splint, made at the same time that the template was fabricated, was placed over the anterior portion of the template and secured with temporary cement (Fig. 10-239) .

At the final visit the acrylic-over-gold full arch splint was cemented with hard cement over the template (Fig. 10-240).

Case 26

A full arch fixed denture for the edentulous maxilla using mixed implants with a template

Well-placed post type implants proved to be far more retentive over a period of time than did the pin implants. As techniques improved, more and more post implants and fewer and fewer pins were used. Combination of the two types of implants was acceptable only when the bulk of the support came from the post type implants, as in the following case using internally threaded vent-plants.

There was adequate bone anteriorly to insert five vent-plants (Fig. 10-241) . These were inserted one by one (Fig. 10-242) until their ends were al-

Fig. 10-241. An edentulous maxilla.