Fiber-Reinforced Hybrid Prosthesis Veneered With Composite Resin for 4 Implant–Supported Fixed Provisional and Definitive Restorations
This technical note describes the fabrication and benefits of fiberglass-reinforced hybrid prosthesis veneered with composite resin for 4 implant–supported fixed professional and final restorations. The described prosthesis reduces rehabilitation time, minimizes impression problems, and ensures a passive fit of professional restoration. The prosthesis provides immediate rehabilitation of 4 implants with ease of adjustments and repair during the entire provisional phase. Moreover, it can be easily converted to final restoration with minimal modifications, excellent esthetic results, and reduced costs.
Planning of implant placement according to the all-on-4 protocol.
(a) Silicon cast with stone base for the maxillary, (b) denture mounted casts on the articulator.
Cut grooves (a) in the buccal flanges and (b) in the palatal flanges.
Polyethylene index. (a) Removed segment that represents the contour of the provisional restoration. (b) Reposition the polyethylene index on the cut denture: (c) occlusal view, (d) lateral view.
(a) Drilling implant recesses in the silicone cast. (b) Analogs with the attached abutments inserted in the implant recesses. (c) Prefabricated U-shaped FRC bar on the cast. (d) Modification of the bar using a milling device. (e) The modified bar included in the restorative space of the denture. (f) Polyethylene index over the modified bar. (g) The bar after modification on the silicone cast.
(a) Implant insertion using a stereolithographic surgical guide and flapless surgical approach. (b) Titanium caps threaded to the multiunit abutments in the patient mouth. (c) Cementation (pick up) of the FRC bar to the titanium caps in the patient mouth. (f) Verification of the occlusal relation with opposing teeth. (d) Verification of fit of the polyethylene index without interference with the bar. (g) Seating the polyethylene index with the composite resin over the modified denture. (g) Wood rods emerged through the holes.
(a) Cleaning of screw channels. (b) Provisional restoration unscrewed from the patient's mouth. (c) Finished professional prosthesis. (d) Provisional restoration in the patient mouth.
(a) Abutment analogs connected to titanium caps of the provisional prosthesis. (b) Provisional prosthesis inserted in putty rubber base impression material.
Final restoration: (a) frontal view and (b) occlusal view.
Contributor Notes