A Method for Fabrication of Implant-Supported Fixed Partial Dentures
When restoring a partially edentulous arch with an implant-supported fixed partial denture, the optimal fit and function of the final restoration depend on the fabrication of an accurate impression and the registration of the interocclusal relationship. The present case report presents a method for the fabrication of impressions and the registration of the interocclusal relationship for implant-supported partial dentures. The described method allows the accurate transfer of the implant position and the registration of the interocclusal relationship using transfer key and electroformed gold copings. The key and copings were used to transfer the intraoral implant position to the cast, to position the abutments intraorally, and to facilitate the fabrication of the final partial denture.
Figure 1. (a) Impression system. (b) Impression system in situ. L indicates titanium impression post placed on the implant; R, plastic impression coping. Figure 2. (a) Composite-embedded in vitro cross section of the impression system. (b) Impression with plastic impression copings. Figure 3. (a) Master cast. (b) Master cast with second set of titanium impression posts.
Figure 4. (a) Fabricated transfer key. (b) Transfer key in situ. (c) Bite records. Figure 5. (a) Use of the transfer key for placing the casts in the articulator. (b) Positioning of denture teeth on the master cast with use of the silicon key. Figure 6. (a) Customized implant abutment. (b) Implant abutments with the transfer key on the master cast.
Figure 7. Electroformed gold copings placed onto the implant abutments. (a) Occlusal view. (b) Buccal view. Figure 8. (a) Mock-up milled from clear poly(methyl methacrylate) (PMMA). (b) Temporary fixed partial denture milled from colored PMMA. Figure 9. (a) Transfer of the abutments on the implants using the transfer key. (b) The abutments were transferred and mounted on the implants. (c) Gold copings in situ.
Figure 10. Radiographic assessment of the fit of the implant abutments. (a) Without gold copings. (b) With gold copings in place. Figure 11. The fit of the mock-up was tested. Figure 12. In vitro axial section of the mock-up and the gold coping placed on the implant abutment. MU indicates PMMA mock-up; GC, gold coping; AB, implant abutment; and SO, screw opening of the abutment. Figure 13. (a) Final impression over the mock-up and the gold copings. (b) Temporary fixed partial denture in situ.
Figure 14. In vitro axial section of the implant-supported temporary fixed partial denture (FPD). T indicates temporary FPD; AB, implant abutment; and SO, screw opening of the abutment filled with resin. Figure 15. (a) Final master cast. (b) The metal-ceramic fixed partial denture (FPD) on the master cast. (c) The FPD in situ. Figure 16. (a) Composite-embedded in vitro cross section of a metal-ceramic implant-supported fixed partial denture on a customized abutment. PV indicates porcelain veneering; MF, metal framework; GC, gold coping; PAB, abutment; SO, screw opening of the abutment filled with resin; and SE, selected area (see Figure 19). Figure 17. In vitro axial section of an implant-supported metal-ceramic fixed partial denture on a prefabricated abutment. PV indicates porcelain veneering; MF, metal framework; GC, gold coping; PAB, abutment; SO, screw opening of the abutment filled with resin; and SE, selected area (see Figure 20).
Figure 18. Rehabilitation of a partially edentulous mandible with an 8-unit fixed partial denture supported by 3 implants. (a) Clinical view. (b) Orthopantomograph. Figure 19. Selected area (see Figure 16) ×20 magnification. MF indicates metal frame; CAB, customized implant abutment; and GC, gold coping. Microgap between gold coping and abutment (G1; <1.2 μm) and between gold coping and metal frame (G2; <1.2 μm). Figure 20. Selected area (see Figure 17) ×20 magnification. MF indicates metal frame; PAB, prefabricated implant abutment; and GC, gold coping. Microgap between gold coping and abutment (G1; <1.2 μm) and between gold coping and metal frame (G2; <1.2 μm).
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