Bousquet Philippe, Carayon Delphine, Durand Jean-Cedric
Department of Periodontology and Implantology, Faculty of Dentistry, University of Montpellier, Montpellier, France.
Laboratoire Bioingenierie et Nanosciences UR-UM104, University of Montpellier, Montpellier, France.
Case Rep Dent. 2021 Feb 24;2021:8872277. doi: 10.1155/2021/8872277. eCollection 2021.
Immediate-loaded implants with a fixed prosthesis are a viable option for the restoration of edentulous ridges. Several procedures now allow for the fabrication of immediate-loading provisional and definitive prostheses. However, this complex treatment is not accessible to all patients with budget restrictions. By using a unique master model with a single titanium framework prosthesis can simplify and shorten the treatment, as well as reduce costs. After surgical placement of implant fixtures, an interim prosthesis was fabricated using a laser-welded definitive titanium framework. The prosthesis was fitted intraorally following the immediate loading protocols. The master cast model used to fabricate interim prosthesis was conserved and subsequently used in modifying the final prosthesis. After the healing process and complete soft tissue stability, an impression was made to register the clearance between the gingiva and resin. The light silicone material was directly injected under the prosthesis screwed in the mouth. In the master cast model, the stone was eliminated between the implants and a new plaster was poured to modify the crest profile with the posthealing new shape. With this modified model, it is possible to rehabilitate the denture to the new gingival anatomy in 3 to 4 hours and, if necessary, the tooth rearrangement. This "one shot" concept combines the single definitive titanium welded framework and limited laboratory work with a unique master model thereby decreasing the cost and the time of treatment.
即刻负重种植体联合固定修复体是修复无牙颌牙槽嵴的一种可行选择。目前有多种方法可用于制作即刻负重的临时和最终修复体。然而,由于预算限制,并非所有患者都能接受这种复杂的治疗。通过使用带有单个钛框架修复体的独特主模型,可以简化和缩短治疗过程,同时降低成本。在手术植入种植体基台后,使用激光焊接的最终钛框架制作临时修复体。按照即刻负重方案在口内安装该修复体。用于制作临时修复体的主模型被保存下来,随后用于修改最终修复体。在愈合过程完成且软组织完全稳定后,取印模以记录牙龈与树脂之间的间隙。将轻质硅橡胶材料直接注入拧在口中的修复体下方。在主模型中,去除种植体之间的石膏,倒入新的石膏以根据愈合后的新形状修改嵴轮廓。利用这个修改后的模型,可以在3至4小时内使义齿适应新的牙龈解剖结构,如有必要还可进行牙齿重新排列。这种“一次性”概念将单个最终钛焊接框架和有限的实验室工作与独特的主模型相结合,从而降低了治疗成本和时间。