1)Cost of the Procedure: Prosthetic costs Sky Rocket due to the rising costs of Gold
2) Timing of the Procedure: These patients are not used to walking around without teeth ever and more importantly are not responsive to wearing a removable prosthesis
3) Large Reconstructions on Implants: When doing these cases Metal Support can get expensive and Porcelain can chip very easily. Over time these are not easy to do and to fix.
4) Transition of the tooth borne to implant borne prosthesis
So we need an approach. Here is the Patient at initial presentation
Consult is done and patient requests only fixed. We discuss options and immediate load is prescribed. Patients do not want to wear dentures during the healing period. Whenever they due they are pressed for healing time, they put pressure on the office and doctor. Not a good situation. With fixed temporaries they are better then when they came in and they are happy on the way out. Impressions are taken for BIOTEMPS to be Fabricated.
Biohorizons implant used due to thin tissue patient has and the LASERLOK feature to maintain tissue.
Biotemp is fabricated as open trench and placed in an essix retained for use as surgical guide and abutment height adjustment guide. palate lets us know if it is seated.
All Upper teeth are extracted and GuideTemp Tried in.
Implants placed, Sutures, abutments. No Flap
Post Reline of Biotemp
Immediate post op. Contour will be played with as healing goes.
Patinet Smile Day 1 of Surgery
Post op X-rays
Two Week Post Op
10 week removal and Impression Closed Tray
Temps are Duplicated with Essix ( or use the original essica made at surgery) Fill with clear bite reg and Bite and Kois taken. Midline Noted.
Titanium Undercasting Tried in and NEw BR taken
Final Restoration on Model.GC Gradia. Easily repairable. Beautifully Constructed
WOOPS> Midline is off!
Info Transfered to Lab
Final Restoration after Midline Fixed.
Jonathan Abenaim DMD DICOI
Uwe Mohr MDT