PMC5394411_01
Patient's preoperative panoramic view.
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All maxillary teeth had unfavorable C/R ratio and were hopeless according to severe caries and severe periodontitis (Figure 1).
Panoramic view after implant insertion.
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So the clinical decision for the maxilla was extraction of all remaining teeth and insertion of six implants (Figure 2).
(a): Intraoral view of the interim immediate obturator (IIO) with tissue conditioner (TC) applied. (b): intaglio surface of the IIO.
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Immediately after surgery, tissue conditioner (TC) (COE-COMFORT, GC, America) was applied in the intaglio surface of IIO (Figure 3(a)). TC was applied again (Figure 3(b)). Two weeks later, primary impressions with irreversible hydrocolloid (Kerr, USA) were taken.
15  angled abutments and bar and balls were placed and torqued.
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Associated ball and bar attachments (Rhein83 Srl, USA) were selected (Figure 4).
Delivery of the maxillary definitive obturator (DO) and 5-unit FPD.
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ISO was inserted in the patient's mouth simultaneously (Figure 5). In order to make functional impression at the end of delivery appointment,
TC was applied to the tissue surface of the DO in order to obtain the optimal peripheral seal.
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TC (COE-COMFORT, GC, America) was used to improve the peripheral seal and consequently speech ability (Figure 6). The patient was instructed to use the
Delivery of mandibular-implant-supported restorations.
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ISO day and night and only remove it for oral hygiene. In the mandible, implant-supported FPD and crown were selected (Figure 7).
Delivery of the soft guard to protect the maxillary 5-unit FPD.
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A soft guard was fabricated on the maxillary FPD (Figure 8).
DO with TC was processed again and delivered.
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ISO with applied-tissue-conditioner was poured and processed again (Figure 9).