Cas cliniques
Dr Jean-Baptiste
VERDINO
Hyères - France
Mr Jean-Michel
MOAL
Immediate loading
Mr Gilles
GIORDANENGO
All Prolab dental lab
Immediate loading in total eduntulous with Axiom® TL (Tissue Level) implants
A 64-year-old female, with no dental history, eduntulous for over 10 years, is not wearing her full denture. The opposite arch is restored with a conventional fixed prosthesis.
1- Presence of bone in the premaxillary bone [Bedrossian zones 1 and 2 ]- indication for All-on-4 type of restoration with angulated implants along the anterior sinus wall.
2- Edentulous arch.
3- Identification of the wall of the sinus wall for placement of the distal implant.
4- Placement of the Axiom® TL (Tissue Level) implant, distal angulated.
5- Sutures around the healing abutments.
6- Transfers in place ready for the post-surgical impression to produce the immediate prosthesis.
7- Plaster impression, which ensures precision and passivity.
8- Temporary abutments: they are covered with a layer of silane and opaque to improve the adhesion of the resin and therefore the solidity of the temporary bridge.
9- Angulated abutments are used for the posterior implants.
10- Immediate screw-retained prosthesis polished.
11- Post-operative panoramic X-ray follow-up.
12- Production of a final bridge after 4 months’ healing period: model is inspected to make a validation key.
13- Wax impression of the screw retained occlusion.
14- CAD concept image of the Simeda® maxillary frame. In the posterior sector, the screw channels in yellow and the implant axes in blue show the angulation of the screw channels.
15- Simeda® titanium frame and integrated fitting locks.
16- Final bridge with soft tissue and composite teeth.
17- Bottom surface view, note the gum-titanium contact and the “gaps” to facilitate the use of brushes for better hygiene.
18- Panoramic X-ray with final bridge.
19-Intrabuccal view of the finished bridge.
20- Occlusal view of the final bridge.
21- Easier use of brushes.
22- Smiling again, with no palate or glue for the first time in over 10 years.
Conclusion
The use of the new Axiom® TL (Tissue Level) implants in this case has had many advantages: the inLink® connection allows the adjustment of extreme axial differences between the two implants, eliminating the need for placement of an intermediate angulated abutment. The laboratory components simplify the production of the immediate prosthesis and the inLink® integrated locking system with guiding locks allows easier insertion. All this, along with complete Simeda® CAD CAM technology, ensures a highly reliable product.
