Maxillary endosseous implant interventions 453

Fig. 10-252. A postoperative Panorex reveals the five vent-plants, two posterior triplants, scalloped template, and posterior palatal connecting bar. Notice also that this patient had lower vent-plants that he had been using successfully for 3 years previous to the upper re-construction. Since the lower posterior pontics were constructed mostly of acrylic, only the gold occlusal surfaces are seen.

Fig. 10-253. The scalloped "tube template" with double rails on both posterior quadrants.

Case 27

A full arch fixed denture for the edentulous maxilla using the tube template and mixed implants

The tube template, designed by Linkow, is scalloped, allowing soft tissue invagination between the interproximal embrasures and providing greater surface for a frictional grip of the denture. Its buccolingual width approximates the outline of the natural teeth. Because the tubes open directly to the mucosa, it is easier to insert post type implants.

The hollow tube template was fabricated from the master cast poured from the elastic impression

Fig. 10-254. The superstructure was cast and processed at the same time that the template was done.

taken of the edentulous maxilla (Fig. 10-253). An opposing jaw alginate (irreversible hydrocolloid) impression was also taken and, because the bite was accurate enough, the superstructure—in this case, a full arch fixed denture—was fabricated at the same time that the template was cast (Fig. 10-254). Using a denture adhesive cream on the tissue-bearing side, the template was placed into position on the soft tissue (Fig. 10-255).

To start implant insertion, round or spear-point burs were drilled through the hollow tubes into bone. Various sized helical burs replaced the initial burs