Atypical implant situations 633

to fit exactly into the hollow cores of the prefabricated metal template. Interrupted sutures were used to close the tissues over the exposed bone, and the maxillary prosthesis was temporarily placed over the five remaining posterior teeth. The anterior quad-rant was screwed into the female threadings of the template.

Five days later the sutures were removed. The bridge containing the five porcelain-fused-to-metal crowns and template was cemented with oxyphosphate of zinc cement over the posterior teeth and

anterior implants (Fig. 15-16). The anterior quad-rant was then screwed into the template (Fig. 15-17), and the occlusion was adjusted (Fig. 15-18).

Healing took place uneventfully. Upon completion of the case, the patient enjoyed a fixed instead of a removable partial denture. Esthetically his mouth, teeth, and lips exhibit a more natural appearance than previously (Fig. 15-19), and functionally the patient is more than satisfied.

A posteroanterior roentgenogram (Fig. 15-20) and two lateral plate radiographs (Fig. 15-21) show

B

D

A

C

Fig. 15-12. A, The tissue-bearing side of the template and castings are seen with the waxed anterior quadrant of teeth. The bar with its two sets of internal threadings is waxed inside. B, The occlusal view of the porcelain and template is seen with the anterior wax-up. C, The waxed anterior quadrant is fitted over the template on the master cast (left side view). D, The right side showing the wax-up and posterior porcelain restorations.