logo 50 | the Camlog Partner Magazine logo 50 | the Camlog Partner Magazine 16 | Case study Case study | 17 7. While the implants in the upper jaw healed under the mucosa-supported full denture, the patient's lower jaw was restored with the interim provisional milled from a multichromatic PMMA blank. 8. Four months later, the upper jaw had healed without inflammation and with sufficient soft tissue volume, so that the COMFOUR bar abutments could be screw-retained on the implants after disclosure. 9. The lower jaw also revealed a well-healed soft tissue situation around the implants after removal of the interim provisional. The angled COMFOUR bar abutments are clearly visible distally. 10. After an intraoral scan at abutment level and a squeeze bite, the functional and esthetic work for the planned prosthetics was started. To do this, an initial digital setup was made, which was also the starting point for subsequent blocking of the open impression taking and served as the basis for the digital centric registration. 11. Using the scans of the upper and lower jaws, a centric registration was created digitally with the Centric Guide® (theratecc, Chemnitz) as a basis for planning and milling the temporaries designed according to the planned final restoration. 12. X-ray check of the impression posts in the upper jaw for a gap-free fit prior to open impression taking for the esthetic-functional final temporaries. COMFOUR bar abutments are screw-retained in the lower jaw. 13. The precise transfer of the oral situation to the model and the check for a tension-free fit of the final temporaries as full-arch frameworks on angled implants was performed intraorally with autopolymerized splinted impression posts. For open impression taking of the implants at abutment level in the upper jaw, a FU tray was printed digitally on the basis of a new scan. Impression taking itself was performed according to the Landsberg concept for an optimum esthetic result as an analog impression using the double-mix technique. 17. After an initial check of the fit on the duplicated master cast, DEDICAM® returned the materials to the laboratory where, after rechecking the fit, the titanium bases were CAD/CAM bonded tension-free to the framework on the master cast. 18. The designed superstructures were first milled from plastic and connected to the metal framework for try-in. As there were no problems whatsoever in terms of fit, fabrication of the ceramic crowns could be started by scanning the final wax-up again. 15. Plastic temporaries designed along the principles of esthetics, phonetics and function for a trial run of several months for acceptance or correction by the patient. For this purpose, the first set-up of interim temporaries was uploaded as in-situ models and adapted to the new situation via matching. The patient wore the final temporary restoration for two months on a trial basis. After she had no correction requests and "coped very well" with the temporary restoration, fabrication of the final restoration could commence. To this end, the temporary restoration was digitally reduced and sent as an STL file to DEDICAM® for milling a titanium framework.
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