492 Theories and techniques of oral implantology

made and the case was ready for final cementation. (During this procedure it was imperative to use a slow-setting cement.)

The teeth were dried thoroughly and the cement applied to the lingual surfaces of the teeth and to the splint, as well as to the interiors of the full crown restorations. The prosthesis was then inserted into position. Next, the plastic-headed screws were coated with cement by dipping them with a rotating motion. The screws were then inserted through the labial surfaces of the anterior teeth. Although these screws are interchangeable, they were used in the same order as before to avoid minor complications. The screws were inserted by hand until each metal head on the screw engaged the labial surface of the teeth (Fig. 11-94). The cement was removed after it set. The plastic heads protruding from the labial surfaces and the projecting pins on the lingual side were then removed with a standard carbide bur. The surfaces were then polished smooth (Fig. 11-95). For maximum esthetic value, the labially exposed

pins could have been indented and the holes filled with silicate or acrylic materials.

A periapical intraoral radiograph shows the blade in position (Fig. 11-96), while the articulation is seen in Fig. 11-97.

Case 9

Aiding bone regeneration in an implant case with plaster of Paris

The addition of plaster of Paris to open sockets appears to encourage more rapid bone regeneration. The calcium salts in plaster seem to have an affinity for the bone-forming cells in the periosteum and endosteum. In orthopedic surgery, experimental and clinical studies on the use of plaster of Paris have been done by Bahn, Bonnerot, Calhoun, Gourley, Lebourg, Blackledge, Greene, Arnold, Biou, Pelletier, Radentz, Collings, and Tarsoly.

Dreesman in 1892 was one of the first to report on plaster of Paris implants. In a report in 1964 by Bell, plaster of Paris was found to show the most

Fig. 11-95. After cementation, the projecting pins were cut flush with the teeth.

Fig. 11-96. The blade in position. Although the implant is shallow, its extreme mesiodistal width ensures retention.

Fig. 11-97. The completed case articulated.