Clinical Continued »
implants, the upper lateral incisors were extracted and the remaining four anterior teeth were prepared for a six-unit bridge. Using a prefabricated stent made from a diagnostic wax-up, a six-unit provisional bridge was made chair-side using Schottlander’s Quicktemp. The implants were then left
to heal and osseo-integrate and the soft tissues to settle. After three months, the provi-
sional bridge was removed and all six Straumann implants were uncovered and checked for stability using the Osstell ISQ device. This gives an objec- tive reading as to the implants’ stability and can be compared to the reading taken at fixture placement. Once osseo-integration
had been confirmed, the remaining four anterior teeth were extracted, and Strau- mann provisional abutments (synOcta Post for temporary restorations) were placed in the four anterior implants with healing abutments in the two most distal implants. The same prefabricated stent
was then used to provide an eight-unit bridge, fully supported on these front four
Fig 3
Fig 4
implants. The tissue and the extraction sites were left to heal for one month before the patient was seen again to take full arch impressions. Stuart Smith and his team at
West Surrey Dental Laboratory (WSDL) in Walton-on-Thames (0ı932 253402,
wsdl.co.uk) undertake all my laboratory work – from single crowns on teeth and implants to these complex full arch cases. For this
case, they now provided a wax bite block and denture try-in. Once the final 3D design had been checked and agreed, the lab then took over for the next stage, fabrication of the final prosthesis. Dentsply Implants has a great
new product which fits the bill perfectly here. Called Atlantis ISUS 2inı, it is a milled titanium bar and matching bridge which is patient removable. The bar
or primary superstructure is connected directly to the fixture heads and can be milled to connect to more than 250 implant systems. The bridge, or secondary
superstructure, fits over the bar by friction fit and then, in our case, locks into place by using pins with a button head towards the back of the
Continued »
Fig 5 The milled titanium bar
Fig 6
Another view of the bar prior to placement
Fig 7 Bar in place
Fig 8 Bar in place
Fig 9 The bridge prior to placement
Fig 10 Side view of the bridge
Scottish Dental magazine 57
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