sky fast & fixed – temporary restoration · the sky fast & fixed therapy provides a good...
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Burzin Khan, Mumbai, India
Adaro Dental Laboratory Mumbai
SKY fast & fixed – temporary restoration
Introduction
Case description
Conclusion
After total extraction in the mandible, the foramen was located and the position of the
distal implants was planned above this. The midline was marked and, using the
angulation guide, the distal implants were placed at an angle of 35˚. The anterior
implants were placed equidistant from the midline in the lateral incisor region. This
provided an even distribution with a maximum spread to support the cantilever. After
the extractions in the maxilla, the position of the distal-most implants was marked in
the region of the second bicuspid and the angulation of the anterior wall was noted. It
may sometimes be necessary to make a small lateral opening to confirm this. The
trans socket cortical stabilisation gave good primary stability. The parameters of
immediate loading of the provisional were as follows:
1) Primary stability app. 45 Ncm²
2) Cross arch splinting within 24-48 hrs
3) No cantilevers
4) Occlusion to be well supported in the anterior segment from canine to canine
The SKY fast & fixed multi unit abutments were fixed with a torque of 25 Ncm². A
closed tray impression was made and the models were articulated using a silicone
bite and a trial wax-up of the arch was completed. An index of this set up was
prepared and the teeth were set in this index after melting away the wax. Acrylisation
of the provisional was made, engaging one titanium cylinder and using a silicone
sleeve on the remaining to provide space for the reline material. The under surface of
this prosthesis was made convex for maintenance and hygiene purposes. The
prosthesis was seated in the mouth and the other titanium cylinders were engaged
using Q resin and its activator. This ensured a passive fit of the prosthesis. The
provisional was polished and fitted into the mouth. The engaging screws were
torqued at 15 -18 Ncm² and the access screw opening was sealed using fermit
temporary resin.
This case describes a 61 year old female patient with multiple missing teeth and
mobile upper and lower front teeth. She was unable to chew with an existing
removable partial denture in the mouth. She wanted a fixed replacement but did not
want to be without teeth in the interim period.
The clinical examination and radiological investigations revealed chronic generalized
periodontitis. Pneumatisation of the sinuses was also present, but the patient did not
wish for grafting to be performed. It was decided that total extraction should be
performed along with full mouth reconstruction with extraction, immediate implant
placement and a provisional prosthesis, using the SKY fast & fixed technique.
The SKY fast & fixed therapy provides a good treatment option for a resorbed ridge
as it provides immediate function and aesthetics restoration. It is a graftless option
and hence saves time and many surgical procedures. Long tilted distal implants
provide a good spread and a stable support for immediate loading with transcortical
fixation. However the protocols must be strictly followed. The patient has been very
satisfied with the treatment and has readily accepted the limitations in function, as the
aesthetic result of the temporary restoration has already shown a significant
improvement.