Bicon Dental Implants
Sunday, March 14th 2010 3:07PM EDT

Porcelain Fused to Metal: Restoration of Two Mandibular Molar Implants with Porcelain Fused to Metal Crowns
This case demonstrates the two-stage surgical uncovering, abutment placement, temporization, abutment level transfer impression, and laboratory and chairside restoration of two mandibular molar implants with porcelain fused to metal crowns.
     


1. Pre-operative site.


2. Radiograph of two 5.0mm x 8.0mm HA coated implants.


3. A 5.0mm x 6.5mm non-shouldered abutment being inserted into the well of the implant.


4. View of two 5.0mm x 6.5mm non-shouldered abutments.


5. Abutment being tapped to engage its locking taper connection with its implant.


6. A 5.0mm acrylic sleeve being placed onto the non-shouldered abutment.


7. A second sleeve being placed on a non-shouldered abutment.


8. Acrylic sleeve being adjusted for occlusal clearance.


9. Transitional composite material being added to acrylic sleeves to form a transitional prosthesis.


10. Transitional prosthesis being snapped onto non-shouldered abutments.


11. Transitional composite prosthesis incorporating two modified acrylic sleeves snapped onto abutments. Note amalgam tattoo.


12. Radiograph of transitional prosthesis.


13. After initial healing, the transitional prosthesis was removed and a 5.0mm yellow acrylic sleeve is being placed onto the non-shouldered abutment for the making of an abutment level transfer impression.


14. Second 5.0mm yellow sleeve being snapped onto a 5.0mm non-shouldered abutment.


15. Impression material being injected around yellow acrylic sleeves for the making of an abutment level transfer impression.


16. A 5.0mm yellow abutment analog being inserted into a 5.0mm diameter yellow acrylic sleeve within the transfer impression.


17. A second 5.0mm diameter yellow abutment analog being inserted into a 5.0mm diameter yellow acrylic sleeve within the transfer impression.


18. Soft tissue material being injected around abutment analogs snapped into yellow acrylic sleeves.


19. Two 5.0mm diameter yellow acrylic sleeves snapped onto two yellow metal abutment analogs in a stone model.


20. Yellow acrylic sleeve and abutment analog being cut to allow for occlusal clearance.


21. Two modified acrylic sleeves and unmodified and modified abutment analog.


22. Acrylic sleeves being incorporated into wax pattern for metal castings.


23. A modified and unmodified abutment analog in a stone model.


24. A modified acrylic sleeve with a groove to indicate its buccal side is on an occlusally modified abutment analog prior to being used intra-orally as a corrective coping.


25. A metal casting and acrylic sleeve on yellow abutment analogs.


26. Yellow acrylic sleeve being used to indicate level to which non-shouldered abutment must be reduced occlusally prior to the try in of a metal casting.


27. Anterior abutment modified to level of yellow acrylic sleeve.


28. Metal casting being placed on anterior abutment.


29. Metal casting being placed on posterior abutment.


30. Two metal castings on non-shouldered abutments. Note amalgam tattoo of cervical tissue of anterior restoration.


31. Two porcelain fused to metal restorations on abutment analogs.


32. Mirror view of two porcelain fused to metal restorations.


33. Minimal cement being injected only at the cervical area of the crown.


34. Porcelain fused to metal restoration prior to being cemented intra-orally.


35. View of cemented porcelain fused to metal restoration. Note the amalgam tattoo, which has been present throughout the treatment.


36. Post-operative radiograph of two porcelain fused to metal restorations.
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