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28 | IDENTITY 13_Transfer index for positioning the copings 17_All components prepared in the laboratory for the supra-structure 14_Galvano flaps as mesial structure, passive fit procedure 15_Cercon scaffold fitted to mesial construction SURGICAL PROCEDURE AND TEMPORARY RESTORATION The teeth in the lower jaw were extracted and six implants were placed interforaminally simultaneously in region 33-43. The patient received a metal-reinforced denture as a temporary long-term solution. A Cercon bridge was fabricated for the upper jaw at the same time. This gave the patient a satisfactory functional and esthetic solution for the next few months. PROSTHETIC AND LABORATORY PROCEDURE Ankylos Balance posterior copings were selected for the six lower jaw implants. They were ground first and then fitted with custom-fabricated Cercon abutments. The Cercon abutments were cemented to the Balance copings in the laboratory and a transfer template was fabricated as an index. A single-component Cercon bridge with Galvano mesial construction was planned. Galvano caps were fabricated for later cementing to the Cercon bridge to prevent tension within the Cercon bridge combination and to achieve a passive seating. In the next step wax provisional of the lower jaw bridge over the Galvano caps was fabricated. They were veneered with Cercogold spacer (DeguDent, Hanau/Germany) beforehand to simulate the cement gap. The Cercon bridge was waxed up, scanned, milled and sintered in the classical Cercon process and then fitted over the Galvano caps and veneered. The Galvano caps were cemented in the mouth with the finished Cercon bridge and plugged on the copings because of the accurate friction fit. 18_Fixing the copings in the mouth with index 16_Detail view of the Cercon veneering 19_Customized copings screw-retained 20_Galvano caps prepared for cementing
21_Intraorally cemented Galvano caps with the Cercon supra-structure 22_Detail view of cementing 25_Lateral detail view 26_Lips and laugh line 23_X-ray check of finished supra-structure CONCLUSION The advantages of working with the Ankylos system, in cooperation with a highly qualified dental laboratory and the techniques described in the article mean the achievement of improved predictability of the expected results and long-term success rates. In the past it was often difficult to fit larger reconstructions in particular accurately. In our practice we have found that all work in which we use Galvano mesial construction has an absolutely accurate fit. The good results are highly motivating for all involved. ■ Dr. Igor Cêch Darryl Millwood C.D.T. Dr. Igor Cêch Kupelny ostrov 13 92129 Piestany Slovak Republic www.dental2001.sk 27_Harmonious nose and mouth view IDENTITY | 29 24_Supra-structure after delivery of prosthetics Darryl Millwood C.D.T. Von Brug Str. 2 82467 Garmisch Partenkirchen/Germany Phone 0049 (0)8821 18882 28_After 12 months the white-red esthetics has further stabilized
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