The patient presented with the need to rehabilitate third quadrant in the region of elements 35 and 36, following the avulsion of element 36, seriously compromised. At the patient’s request, we did not proceed with the immediate post-extraction insertion of the implants, but opted instead for deferred insertion. Four 4 months after extraction we therefore used the flapless technique to insert two Shelta implants (Sweden & Martina), respectively of diameter 3.80 mm and length 11.5 mm at position 35 and diameter 4.25 mm and length 11.5 mm at position 36. On both implants an insertion torque of 65 Ncm was used. Two final conical posts with reduced diameter were positioned on the implants, for use with the conometric prosthetic system (Sweden & Martina). In the same surgical phase the preformed conometric caps were positioned (Sweden & Martina). The caps were fixed by intraoral welding (Dent Weld, Sweden & Martina), using a titanium bar with diameter 1.5 mm. The result was an extremely precise removable prosthesis that allowed us to make a temporary prosthesis for immediate loading.
The welded caps were removed to check their passivity and to verify that they could be incorporated into the prefabricated temporary prosthesis. After the electrically-welded structure was repositioned on the posts, the temporary prosthesis was directly relined, so as to be able to incorporate the structure itself to obtain a reinforced removable prosthesis that would also have the advantage of stabilizing the implants.
Conclusions: The case presented shows that with this technique an implantoprosthesis for immediate loading that respects the concepts of platform switching can be made quickly and easily, positioning the final post that will remain in place in the surgical phase, thanks to the availability of posts with different transgingival heights. The use of prefabricated conometric caps allows a very high level of precision to be obtained, and fixing with electric welding makes it possible to stabilize the inserted implants and to proceed with the chairside construction of a temporary prosthesis that is not only extremely resistant, but that can also be easily removed by the dentist at any time. The standardization of the method and its adaptability to the various Sweden & Martina implant systems the reasons for its ease of use and consequent inexpensiveness.
