Stabilization of the maxillary teeth with fixed splinted restorations was considered inappropriate because of possible risk factors such as localized abutment failure. Splinting of telescopic restorations was considered to be as effective as that of FDPs. These restorations can be retrieved for repair and oral hygiene maintenance during long-term follow-up. Thus, a telescopic prosthesis was considered a better treatment option with promising

results. For implant placement, the patient was referred to the Department of Oral and Maxillofacial Surgery. Two dental implants (SLA® implants, Standard RN ø4.8 mm, 8 mm, and 10 mm; Straumann, Basel, Switzerland) were placed in the region of the mandibular right first and second molar, using a surgical guide. All implants had adequate primary stability at the time of placement. Three months after implant placement, Ceritinib clinical trial impressions of the implants and the prepared maxillary and mandibular teeth selleck products were made using a VPS impression material. A facebow transfer (Hanau Spring-Bows) and maxillomandibular relationship was recorded. The OVD of the interim prosthesis was transferred to the definitive restoration. The casts were articulated to a semiadjustable articulator. The inner telescopic copings of the maxillary telescopic prosthesis were cast and milled to an average wall taper of 6° (Fig 8). After adaptation

was confirmed intraorally, inner telescopic copings were cemented to the maxillary teeth with provisional cement (TempBond). A transfer impression of the telescopic crowns was then made using polyether (Impregum;

3M ESPE, Seefeld, Germany) in a custom-made acrylic impression tray. An irreversible hydrocolloid impression (COE Alginate; GC America) of the interim FDP was also made and poured in type III dental stone (New Plastone; GC Co.), to be used as a guide to fabricate the definitive restorations. The abutments for the mandibular learn more implants were selected (synOcta® Cementable Abutment; Straumann). Wax-ups for the maxillary telescopic prosthesis and mandibular metal ceramic restorations were done. The incisal length and position of the maxillary anterior teeth were determined from the interim prostheses. Full contoured wax-up was then cut back for the porcelain veneer and cast with a noble metal alloy (V-Supragold, Cendres+Metaux, Binne, Switzerland). After confirming the fit of the metal framework intraorally, a veneering porcelain material (VM-13, VITA Zahnfabrik, Bad Säckingen, Germany) was built up (Fig 9). The final fit, esthetics, and lip support of the definitive prosthesis were verified. The inner telescopic crowns of the maxilla were cemented with resin-modified glass ionomer cement (GC FujiCEM; GC Co.). The superstructure was cemented with provisional cement (Tempbond). Abutments were placed on the implants in the mandibular right first and second molars and tightened with 35 N torque.