PMC3886099_01
Master cast with implant analogs in place.
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fig1
After a period of six-months and complete healing of the graft sites, the interim restoration was removed and an implant level impression was made, followed by the construction of a master cast (Figure 1).
Vacuform template relined over implant mounts.
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The vacuform matrix was then filled with clear, auto-polymerizing acrylic resin (Orthodontic Resin, Dentsply Caulk, Milford DE, USA), carefully placed in the cast and secured with rubber bands (Figure 2).
A = intaglio view of the template after polishing; B = cameo view of the
template after polishing.
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fig3
The acrylic resin was allowed to set in a pressure pot for ten minutes at which point it was removed and the excess material was trimmed and polished (Figure 3A and 3B).
Template retained on implants prior to implant positioning.
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During the second surgery the surgical template was screw retained to the existing implants after tissue reflection (Figure 4).
Master cast with implant mounts in place.
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A master cast was made of the remaining three implants in sites #36, #43 and #46 (Figure 5).
Vacuform template relined over implant mounts.
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fig6
A vacuform matrix (Invisacryl A, Great Lakes Orthodontics LTD, NY, USA) fabricated from the original wax-up was relined over two implant mounts (Straumann USA, Andover, MA, USA) on implant analogs at sites #36 and #43 utilizing clear, auto-polymerizing acrylic resin (Orthodontic Resin, Dentsply Caulk, Milford DE, USA) (Figure 6).
A = intaglio view of the template after polishing; B = cameo view of the
template after polishing.
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fig7
The template was trimmed, polished and sterilized prior to surgery (Figures 7A and 7B).
Template retained on implants prior to implant positioning.
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fig8
At the surgical visit, once the tissue was reflected at site #33, the template was placed onto implants #36 and #43 and provided a clear visualization of the desired implant position based upon the planned restoration (Figure 8).