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12. Laboratory Procedure and Prosthetic treatment.
A master cast is made and gold bar copings are mounted on the implant analogs with the coping screws. The pre-fabricated round gold bar should be parallel to the occlusal plan and the bar should be positioned at least 2 mm above the gingival tissue to allow for proper hygiene.
It is a matter of opinion how fast you want to deliver the bar construction to the patient. We normally evaluate the fit of the bar construction 8-10 days later, when the sutures are removed. It is easier to control the fit of the bar construction, when the swelling has subsided and the healing is in progress. It is also more convenient to make the impression for the overdenture at this moment. Bar coping screws should be tightened to a torque of 24 Ncm with the 1.22 mm hex driver. In this case the fit of the bar was evaluated 4 days later.
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The bar construction in place 4 days postoperative.
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Food impaction often occurs beneath the overdenture within one or two months after delivery in the immediate procedure due to the shrinkage of the soft tissue in the postoperative period. At this moment it is necessary to reline the overdenture once more.
Careful instruction in oral hygiene with round brushes should be done as soon as the bar is delivered to avoid mucosal hyperplasia beneath the bar construction.
The bar construction and the overdenture 3 month postoperative.
The overdenture has recently been relined.
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