PMC4299766_01
Initial clinical features.
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fig1
Given the clinical (Figure 1) and radiographic features, it was proposed to extract the remaining lower teeth and place an immediate loading implant-fixed mandibular prosthesis.
Multifunctional guide.
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Thus, a multifunctional guide (Figure 2) was fabricated from a duplicate of the wax base, after the first clinical proof, to maintain the esthetic and dimensional features obtained previously.
Abutments installed on the implants.
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fig3
Comercio de Produtos Odontologicos, Itu, SP, Brazil) with a greater torque than 40 N cm, the abutments were installed (Figure 3) and an impression was performed using the multifunctional guide. Cylinders that were previously cast in Ni-Cr alloy (Fit Cast SB-Plus Ni-Cr without Beryllium, Talladium, Curitiba-PR, Brazil) were installed on the abutment replicas in the master cast.
Fragments previously cast in Ni-Cr alloy inserted into the space between the cylinders.
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fig4
Fragments were earlier cast in Ni-Cr alloy and obtained by means of wax patterns and inserted into the space between the cylinders (Figure 4).
Framework after finishing.
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Finally, the finishing in the framework with stones and disks and blasting with aluminum oxide (100 mum) was performed (Figure 5).
Framework try-in.
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Then, it was performed the framework try-in on the abutments by first tightening down one of the terminal screws completely (Figure 6).
Prosthesis immediately after installation.
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After these procedures, we performed a clinical evaluation of the teeth and, after the confirmation and approval of the patient, the prosthesis was installed in 12 hours after surgery (Figure 7).
Panoramic radiograph after 12 months.
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Figures 8 and 9 show the radiographic and clinical features of the prosthesis 12 months after the installation.
Clinical aspect of the prosthesis after 12 months.
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fig9
Figures 8 and 9 show the radiographic and clinical features of the prosthesis 12 months after the installation.