immediate loading, screw retained provisional with peek ... · immediate loading, crew etained...

Immediate loading, Screw Retained Provisional withPEEK abutmentCase Study

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Immediate loading, Screw Retained Provisional with PEEK abutment

● 56 year old healthy male● Full occlusion, failing bridge 14XX17● Tooth 14 supporting 14XX17 diagnosed as hopeless

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Immediate loading, Screw Retained Provisional with PEEK abutment

- Site 14 has diminished coronal bone- Sites 15,16 have Good Initial Bone Support- Bicortical fixation is plausible

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Immediate loading, Screw Retained Provisional with PEEK abutment

- Extraction & immediate implantation of 14- Implants with bi cortical fixation 15,16- Immediate Provisional

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Immediate loading, Screw Retained Provisional with PEEK abutment

A Simplified procedure Planning:- Creation of a Multipurpose Provisional/Guide.- Preparation of tooth 17 and making sure the P/G has good retention

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Immediate loading, Screw Retained Provisional with PEEK abutment

● Initial drill through Provisional/Guide● Removal of guide● Raising Flap● Extraction of 14

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Immediate loading, Screw Retained Provisional with PEEK abutment

● Flap Raised● Implants Under Preparation● Parallel Pins checked● X-Ray

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Immediate loading, Screw Retained Provisional with PEEK abutment

● Rotatory insertion of implants up to 55Ncm● Hand Torqueing of implants 15,16. gained high initial stability.● Notice the buccal gap around 14Implant types PalTop:14: 13X3.715: 13X3.716: 10X4.2

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Immediate loading, Screw Retained Provisional with PEEK abutment

Implant 14 gained medium torque and has a buccal gap● This implant will not support immediate loading● Filling of Buccal bone to implant gap with bone particles and membrane

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Immediate loading, Screw Retained Provisional with PEEK abutment

Peek Abutments to support provisionalConnection to provisional using flowable compositeRemoval for Contouring

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Immediate loading, Screw Retained Provisional with PEEK abutment

Final Contour of Peek Abutments to support provisional

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Immediate loading, Screw Retained Provisional with PEEK abutment

Final Screw Retained Provisional

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Immediate loading, Screw Retained Provisional with PEEK abutment

l PEEK (Polyetheretherketone) is a high-grade thermoplastic polymer, characterized by a superiorl strength, elasticity and resilience. High esthetic results due to its design and off-white colorl PEEK polymer allows easy and quick chair-side modificationl Provides adequate strength to the provisional restorationl Very good biological compatibilityl Excellent mechanical properties such as stiffness, toughness, and durabilityl Prevents thermal conductionl High resistance to repetitive mastication forcesl Less forces transmitted through polymerl High chemical resistancel Can be sterilized without degradation in mechanical properties or biocompatibilityl X-ray/CT compatible

Temporization:l Choosing the correct anatomic peek abutmentl Choose the correct inclinationl If the implant is ortho-inclined then create a screw-retained provisionall If the implant is bucally-inclined than you must create a cement retained provisional.

Peek Abutment

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Immediate loading, Screw Retained Provisional with PEEK abutment

Final Screw Retained ProvisionalVertical Mattress Sutures for papillae inducement.

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Immediate loading, Screw Retained Provisional with PEEK abutment

Final Impressions

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Immediate loading, Screw Retained Provisional with PEEK abutment

Final Impressions

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Immediate loading, Screw Retained Provisional with PEEK abutment

Final Impressions

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Immediate loading, Screw Retained Provisional with PEEK abutment

Final Impressions