logo 18 • CAMLOG Partner Magazine • July 2018 25 Fig. 20: The impression was taken with the combined tray. The bite relationship was confirmed by the bites. Fig. 17: The control X-ray shows the screw-retained impression posts and the gingiva former on the central implant. Fig. 18: The surgical site was covered with a rubber dam and the posts were splinted with plastic. Fig. 19: Before the impression was taken, it was checked that the long screws did not interfere with the bite into the plastic bite impression. Fig. 21: The mandibular impression: the "snowshoe pads" in the dorsal area are readily visible. Fig. 13: The flexible handle was pushed to the side for better visibility. The fabrication of the temporary denture In the laboratory, the mandibular master cast was fabricated by inserting the laboratory analogs into the titanium bases, fixing them with the prosthetic screws and filling the impression. Before the impression was taken from the cast, the technician articulated the model against the preoperatively fabricated full denture. Using a silicone index, the preoperatively determined ideal mandibular set-up was transferred from the situation or set-up model to the working model and then modeled in full. After a functional check, the all-plastic bridge over the titanium caps was fabricated using conventional techniques. During finishing, particular focus was placed on the basal design and good hygienic capability of the bridge construction ("cleaning supports"). A few hours after surgery, the temporary restoration could be incorporated (Fig. 22). The healing caps were removed under local anesthesia and the occlusally screw-retained temporary restoration was inserted with 15 Ncm. After the functional check and the provisional closure of the screw access channels, the patient was again informed that she should only chew carefully and eat soft foods. CASE STUDY Fig 11: The abutment was positioned with the aid of the handle. Fig. 12: The abutment screw was tightened with a hand screwdriver. Fig. 22: 14 days after insertion, the definitive metal-plastic prosthesis was inserted and the sutures removed.
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