Implants – Restorations

The single tooth restoration is probably the most popular and achieves excellent results. A single implant crown can be either cemented or screw retained and a choice of abutments can help solve space and angulation issues.

After the placement and healing time has elapsed, an impression using a material capable of picking up the transfer coping is sent to the laboratory. The correct positioning cylinder must be used in the impression to show the lab the correct choice of analog.

Once in the lab a gingival soft tissue model is made to ensure that the crown is contoured correctly and the impression is cast.

The construction of the substructure is meticulous, and involves waxing up the coping using case specific components to ensure the precision fit.  It is possible to use various types of restoration and we have had excellent results using techniques shown in the products section.

An implant retained bridge is available as cemented or screw retained. For screw retained bridges a custom made special tray with perforations for screws and adequate room for the transfer copings is made. It is important that the impression material used should be capable of picking up the transfer copings.

When the gingival soft tissue mask and the impression are cast, a planning kit is used to select the most suitable abutments at the laboratory. There are several abutment choices available for highly technical and difficult cases.

The metal framework is then constructed in your choice of metal alloy to exacting standards in the same way as a conventional wax-up. The porcelain work is completed using the diagnostic wax-up made at the beginning of the case treatment as a guide.

To construct an implant borne denture using retentive anchors requires meticulous planning and care to ensure a successful restoration.

A denture try-in is produced to ensure the perfect design of the base, bite and aesthetics. Time spent at this stage can dramatically reduce subsequent difficulties and errors. The try-in is used to plan the position of the implants, ensuring the height and width of the denture can accommodate the size of the female part of the attachment.

A custom made special tray is made to take the definitive impression with the abutments in place.

A chrome cobalt will be constructed to provide the metal reinforcement, leaving space for the matrices. The denture try-in can then be transferred to the chrome using the detailed information collated at the planning stage. This should be tried in once again without the matrices in place and careful attention paid to the bite and base fit.

Once this stage is complete, the denture will be finished and returned for the patient to wear for a few weeks. This is to assess the fit and comfort of the denture before in volving the fitting of the attachments. In our experience it has been found highly beneficial to let the denture bed in before fitting the matrices. This way we can check that retention is aided with the attachment, rather than supported entirely by the implants and attachments.

There are two types of bar available for bar-borne restorations. The first is Dolder Bar which has an egg shaped profile and the second is a Round Bar.

The planning and pre-operative work is once again all important. A common problem occurs when we are sent impressions with the implants in place but without any knowledge of the position or shape of the teeth. A golden rule is that the bar should be made to the parameters of the denture and not the other way round. Therefore all aspects of the bite, design and aesthetics should be thoroughly worked out before placing the implants.

A try-in is produced for this reason, it not only assists with the planning of placement for the implants, but it can make sure that the height and width of the denture can accommodate the bar structure.

Even if the ridge varies in height when the bar is constructed it must be kept horizontal. Allowing the bar to slope creates problems with the horizontal forces and would impede the function of the bar attachment. The bar is cut to the correct measurement and carefully soldered to the gold copings. Small extensions can be placed distally to the abutments but this is not suitable for all cases.

The bar will be returned to the surgery for a try-in before transferring the wax-up. The bar matrix or riders will be placed to allow for the absorption of the horizontal forces. Care must be taken that the positioning is right to ensure correct function. After a successful try-in the denture can be finished and the matrix processed into the denture.