The aim of this article is to present a case of immediate restoration of an edentulous maxilla with DS PrimeTaper implants (Dentsply Sirona). This case report is published as an inspiration for dental professionals and not necessarily as a recommendation.
A 55-year-old male patient complained about the retention of his maxillary complete denture and requested a fixed solution. Intra-oral examination and radiography confirmed an edentulous maxilla (Figs. 1 & 2).
The dual-scan protocol was used to visualise bone, soft tissue thickness and denture position in the Simplant software (Dentsply Sirona). Four DS PrimeTaper EV 3.6 mm diameter implants were planned according to the position of the patient’s denture, and four Multibase abutments (Dentsply Sirona) were visualised accordingly (Fig. 3).
Prior to surgery, intra-oral scans of the edentulous upper jaw and dentate lower jaw were performed. The existing denture was used first as a surgical guide and then as a provisional prosthesis, after removing the palate (Fig. 4). Immediately after implant placement (Figs. 5–10), abutment position was registered with an intra-oral scan (Fig. 11). The provisional prosthesis was prepared fromthe existing denture (Figs. 12 & 13) and then the Atlantis BridgeBase was designed (Fig. 14).
Eight weeks after implant placement, the soft tissue had healed well (Fig. 15) and was ready for try-in of the Atlantis BridgeBase with a printed wax-up (Fig. 16). The wax-up was later copy-milled in zirconia (Fig. 17). The definitive prosthesis consisting of the Atlantis BridgeBase and zirconia was placed eight weeks after implant placement (Fig. 18).
Fig. 1: Pre-op situation of the edentulous maxilla.
Fig. 2: Pre-op radiograph.
Fig. 3: Implant treatment planning in Simplant using the dual-scan protocol to visualise tooth position as well as abutment position. Four DS PrimeTaper implants were planned for immediate restoration.
Fig. 4: The existing denture was adapted to be used as a surgical guide and provisional prosthesis for immediate loading.
Fig. 5a–c: Implant bed preparation following the recommended drilling protocol for the planned implant using drill #1 (5a)...
Coronal perforation of the cortical layer with drill #4 (5c).
Fig. 6: Implant insertion.
Fig. 7: Multibase abutments inserted for immediate loading.
Fig. 8: The abutments were torqued to 25 Ncm.
Fig. 9: Temporary cylinders prepared with SynCone silicone sleeves (Dentsply Sirona) for intra-oral gluing.
Fig. 10: Intra-oral gluing of the temporary cylinders to the existing denture.
Fig. 11: Intra-oral scan of the abutment position, antagonists, provisional prosthesis and jaw relation for the manufacturing of the definitive prosthesis.
Fig. 12: Seating surface of the provisional prosthesis.
Fig. 13: Provisional prosthesis in place.
Fig. 14: Design of the Atlantis BridgeBase.
Fig. 15: Healed soft tissue eight weeks after implant placement.
Fig. 16a & b: Try-in of the Atlantis BridgeBase without (16a)...
... and with a printed wax-up (16b).
Fig. 17: Definitive prosthesis consisting of an Atlantis BridgeBase and zirconia.
Fig. 18: Definitive prosthesis seated eight weeks after implant placement.
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