Division of General Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA.
Advanced Specialty Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA.
J Prosthodont. 2019 Apr;28(4):473-479. doi: 10.1111/jopr.13034. Epub 2019 Feb 25.
A technique is presented where a custom milled impression coping is used to replicate the clinically established anterior incisal guidance to the definitive prosthesis when multiple implants are restored in the esthetic zone. A conventional impression is initially made, then the stone cast is scanned, and a digitally designed custom screw-retained, implant-supported interim prosthesis is milled from a polymethylmethacrylate (PMMA) billet. This is aimed to digitally design the pontic areas, contour the gingival soft tissue, and establish an anterior incisal guidance. A custom milled impression coping (CMIC) is then fabricated. The CMIC has contours similar to the contours of the interim prosthesis and is fabricated from a PMMA billet. Titanium inserts are placed in the interim prosthesis and the CMIC. The CMIC is inserted intraorally and used for the final impression by using a custom tray and by following the open tray impression protocol. With the proposed technique, the exact contours of the digitally designed and clinically verified interim prosthesis are used to fabricate the definitive restoration.
本文介绍了一种技术，即在多个种植体修复于美学区域时，使用定制的铣削印模帽来复制临床确立的前切导至最终修复体。首先进行常规印模，然后扫描石膏模型，并使用聚甲基丙烯酸甲酯（PMMA）坯料铣削出数字化设计的定制螺丝固位、种植体支持的临时修复体。这旨在数字化设计桥体区域、修整牙龈软组织并建立前切导。然后制作定制铣削印模帽（CMIC）。CMIC 的轮廓与临时修复体的轮廓相似，由 PMMA 坯料制成。将钛插件放置在临时修复体和 CMIC 中。将 CMIC 插入口腔内，并使用定制托盘和开放式托盘印模协议进行最终印模。通过该技术，使用数字化设计和临床验证的临时修复体的精确轮廓来制作最终修复体。
