CATEGORY AUSTRALASIAN DENTIST99 CLINICAL Fig 65 Fig 68 Fig 71 Fig 62 Fig 66 Fig 69 Fig 63 Fig 67 Fig 70 Fig 64 Two months after placing the implants in the lower jaw, a flap was created for tissue augmentation. A connective tissue graft extracted from the patient’s maxillary tuberosity was then adapted around the implants to enhance soft tissue volume. Subsequently, the implants were exposed, healing abutments were placed, and the mucoperiosteal flap was carefully adapted and sutured (Figs. 48-53). After two weeks, healing progressed without complications, and a PMMA resin provisional crown and bridge were placed. These were designed to minimize contact during lateral and protrusive movements. (Figs. 54-56). Prosthetic procedure For the rehabilitation of the maxilla, the temporary fixture was relined, finished, and glazed in the dental lab (Fig. 57). After placing the provisional prosthetic in the patient’s mouth, the neighboring soft tissues were stabilized with U-shaped small-caliber sutures to minimize scarring after healing. This method increased the width of the attached keratinized mucosa and eliminated the need for a connective tissue grafting procedure. As a result, this approach offered an effective alternative for soft tissue augmentation, eliminating the need for secondary surgical access to a donor site and thereby reducing postoperative discomfort (Figs. 58-61). The patient was examined and remained symptom-free. The implants were osseointegrated, and the peri-implant soft tissues healed well with appropriate soft tissue shaping. Final impressions were then taken, and the second temporary restoration was fabricated (Figs. 62-65). The second temporary restoration was delivered, and prosthetic screws were torqued to 15Ncm. (Figs. 66-68). Radiographs confirmed the correct position and satisfactory bone healing around all implants (Figs. 69-71). After six months, the temporary restoration was exchanged for the final milled titanium restoration with a titanium framework. The occlusion and esthetics of the prosthesis were evaluated, the screws were torqued to 15 Ncm, and the access holes were sealed using Teflon and composite resin. The patient was given general oral health guidelines and advised to schedule professional oral hygiene visits every six months. The patient was very satisfied with the results (Figs. 72-84). Treatment outcomes The successful treatment of this patient with fixed restorations using Straumann®
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