Endodontic implants 601

Fig. 13-49. A 5 1/2-year postoperative Panorex showing completed case. The left bicuspid had been removed and replaced with a unilateral subperiosteal implant.

Fig. 13-50. A left cuspid with a completely horizontal fracture of its root midway between its apex and cementoenamel junction was fitted for a gold post prior to further supporting it with an endodontic root stabilizer.

whose root was completely fractured horizontally half-way down its length. The cuspid was first prepared (Fig. 13-50) and then a vent-plant was placed behind it (Fig. 13-51) . After impressions were made, the apical half of the cuspid root was removed through the buccal plate of bone and the endodontic pin implantation performed (Fig. 13-52). A gold post was cemented over the cuspid root and a veneer casting placed over it. Then a gold coping was placed over the vent-plant post. An alginate impression of the opposing jaw, a wax interocclusal record of centric relation, and a plaster index picking up the cuspid casting and implant coping were made for completing the bridge. The bridge was tried and cemented (Fig. 13-53) and a triplant added posteriorly for additional support (Fig. 13-54) . The superstructure was then cemented (Fig. 13-55) .

Radiographs of the case show how each type of implant uniquely serves its particular purpose (Fig. 13-56) .

Fig. 13-51. A, A vent-plant was tapped in the edentulous second bicuspid region behind the cuspid post. B, The shaft of the vent-plant extended 4 mm. out of the fibromucosal tissue. C, An interchangeable prefabricated gold coping was placed over the implant post and its occlusal clearance carefully checked.

A

B

C