Background

A „future-oriented production technique“ is „3-D printing“, more precisely „Additive manufacturing“ (AM). This generative process allows for a „design-driven manufacturing process“ in which the design has virtually no restriction by production parameters.

Material and methods

After the unexpected death of his practitioner, a 55-year-old patient – in the mandible with chairside-manufactured immediate loading on six implants – looked for the author’s practice to complete the treatment. The implants of the Astra Tech Implant System (OsseoSpeed TX) had been placed in 36, 34, 32, 42, 44, 46. The fabrication of the framework, designed by the Atlantis Designcenter, took only a few days, with the suprastructure already sandblasted. Intraorally and on a new master model, the CoCr framework showed with the Sheffield test no misalignment. For the veneering with veneer shells and composite, the framework was prepared as usual and conditioned with metal primer. The screw bearings for the prosthetic screws had also already been milled so the final restoration could be screwed to the abutments without further work.

Results

Care of all implants with UniAbutments 20° and preparation of a 12-membered cobalt-chromium implant bridge, veneered with composite and veneer shells and minimal application of red gingiva.

Discussion

Since all six implants had diverging axes, a skeleton construction with angled screw extensions was necessary for functional and esthetic reasons. Such a construction requires an extremely high passive fit and a corresponding surface quality and structure in order to ensure a reliable function and a long-term stable material combination.