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CASE STUDY 11 Fig. 10: To avoid a sinus lift, a 9-mm CAMLOG ® SCREW LINE implant was inserted in regio 26. tics is trimmed as a pontic. This exerts a slight pressure on the gingiva to produce an anatomical soft tissue scalloping and the interdental spaces are closed by pa- pillae. The diagnostic set-up was trans- ferred to a screw-retained plastic base and the tension-free fit of the bridge as well as function, phonetics, and esthetics were checked in the clinic. The dental technical then carried out the necessary CAD/CAM processes. The scan marker was screwed onto the lab analogs and the model was scanned in the strip-light scanner (Zirkon- zahn) both with and without the gingival mask. The set-up, the opposing jaw, and the articulator situation were captured dig- itally and matched to the data used to de- sign the screw-retained plastic bridge (Fig. 16) . To design the emergence profile, the abutment bases were prepared and the dig- ital set-up was positioned with the help of the in situ scan. The digitally designed construction was milled in tooth-colored plastic (Tembase, Zirkonzahn) with the implant connection fabricated completely in plastic. The fit of the construction was checked on the model, and the holding pins were separated and ground off (Fig. 17 and 18) . The teeth were contoured ful- ly anatomically. Twelve days after exposure of the implants, we inserted the temporary bridge, checked the occlusion and the bite height, closed the screw access channels, and discussed tooth shape and size. We recorded the minor changes the patient requested so that they could be incorpo- rated into the final restoration (Fig. 19) . Fabrication of the full ceramic restoration on eight DEDICAM abutments After five weeks during which the pa- tient had become accustomed to the fixed restoration, we prepared tooth 27 and adapted the implants in the upper jaw to the surrounding soft tissue situation. Our dental technician screwed the impression posts onto the master model for the open tray technique and splinted with Pattern Resin. He separated the plastic bar into individual segments using a fine cutting wheel. We screwed in the impression posts in the mouth and splinted the gaps before taking the impression with Pattern Resin. Noting all the relevant technical cri- teria, the model was fabricated in the lab- oratory, articulated, and then scanning posts were screwed on and the model was scanned. The data for the set-up stored in the software were compared to the cur- rent data. We checked that the implants had been precisely transferred by having a CAD/CAM bridge fabricated from machin- able green plastic. We placed this in the mouth and checked that the restoration fit free of tension. We then prepared the late- ral teeth in the lower jaw to fabricate the zirconia bridges from the first premolar to the second molar. We used the green plas- tic bridge to determine the occlusal dis- tance (Fig. 20) . After the bite registration and impression taking in the lower jaw, Fig. 17: The fit of the direct screw-retained temporary plastic restoration was checked on the model. Fig. 18: The basal view shows the anatomical, pontic-shaped support of the bridge elements. Fig. 16: In the laboratory the data from the backward planning were matched with the current scan of the model. Fig. 11: Using a mixture of autologous bone and bone graft material, smaller bone defects were evened out. Fig. 12: To encourage wound healing, the bone was covered with PRF membranes and the soft tissue was closed up. Fig. 19: The stably seated plastic bridge was inserted to contour the soft tissue.