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The final restoration was fabricated and delivered in just<br />
three appointments.<br />
First Appointment<br />
The patient presented for restoration following the placement<br />
and osseointegration of seven internal hex implants<br />
(Fig. 3). Following sinus grafting, the implants were placed<br />
in the edentulous maxillary arch in key positions: first<br />
molars, canines and central incisor, with the addition of two<br />
other implants for increased support of the prosthesis. The<br />
patient was temporized with a removable overdenture on<br />
Locator ® Abutments (Zest Anchors; Escondido, Calif.) (Fig.<br />
4). This temporary overdenture was used to evaluate esthetics<br />
and vertical dimension and provide function to the patient.<br />
A bite registration was taken to represent the vertical<br />
dimension with the trial denture in position, and a duplicate<br />
of the overdenture was made to guide the fabrication of the<br />
final prosthesis.<br />
Figure 3: Seven implants were placed in the edentulous maxillary arch.<br />
NOTE: Additional implants may be used to increase stability of the restoration<br />
and help preserve crestal bone levels.<br />
To make the final impression, Inclusive ® Scanning Abutments<br />
(<strong>Glidewell</strong> Direct; Irvine, Calif.) were attached to<br />
the implants to capture implant position and angulation<br />
(Figs. 5, 6). These polyether ether ketone (PEEK) abutments<br />
have traditionally been used in the laboratory to scan and<br />
digitize conventional impressions. In this technique, they<br />
are used intraorally to eliminate the working cast altogether.<br />
After a light application of powder to the edentulous<br />
Inclusive ® Scanning Abutments<br />
were attached to the implants<br />
to capture implant position and<br />
angulation. These polyether<br />
ether ketone (PEEK) abutments<br />
have traditionally been used in<br />
the laboratory to scan and digitize<br />
conventional impressions.<br />
In this technique, they are<br />
used intraorally to eliminate<br />
the working cast altogether.<br />
Figure 4: A provisional overdenture with three retentive Locator Attachments<br />
was fabricated.<br />
Figure 5: Inclusive Scanning Abutments were attached to capture implant<br />
depth, position and angulation when the optical impression was taken.<br />
– Optical Impressions and Full-Arch Implant Restorations: A Case Study – 69
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