Abstract
Many denture wearers experience discomfort and speech difficulty due to ill fitting dentures caused by progressive bone loss. Unfortunately, the cost of implants with fixed or removable prostheses is often prohibitive to many. This presentation introduces a universal prefabricated superstructure and abutment mechanism for immediate implant splinting that eliminates clinical impressions and expensive gold castings, providing therapy for under $350.00.

Designed for use with osteocompressive immediate-load implants, this chairside implant-splinting prosthesis utilizes the patient's existing denture for one-visit surgery and restoration. This presentation will feature one clinical case, from diagnosis to step-by-step immediate-load implant placement, and the components for day-of-surgery procedure installation of the immediate chairside implant-splinting prosthetic system.

Material and Method
In a five-year study, three implant-splinting gold bar superstructures of noble alloys were formulated, tested, and clinically studied for size, quality and prosthetic function in conjunction with three abutment types having coupling geometry up to 65º trajectory. In this study, involving 32 patients at four sites, we evaluated these immediate chairside procedures using superstructures and abutment assembly systems to support existing lower dentures. All implants were loaded the day of surgery using the science of osteocompression.1-4

Twelve patients received conventional Ackermann-like gold bars having elastic modulus greater than bone, with and without gold clips. Six of these patients had morse tapered abutments with a mesial distal hole to receive a gold bar secured by occlusal screws (Type A). Six received morse tapered abutments with two prongs for crimping the gold bar in place (no occlusal screw)(Type B).

Twenty patients received Type C prosthetic modality, a thinner gold bar, fully annealed, with elastic modulus lower than bone. The morse tapered abutment secured this gold bar with a threaded occlusal screw cap. The clinical advantage of Type C modality permitted disassembly for clinical examination of implants, treatment and/or implant retrofitting. Immediately following implant placement, all dentures were soft relined at implant areas only, and placed into immediate function.

Conclusion
Type C prosthetic implant splinting modality was more user friendly and cost effective in clinical application than A and B. The fully annealed gold bar with coupling abutments resolved parallel issues, dynamic implant moment force overload, and functions as a suspension bridge cable assembly to flex with mandibular demands, preventing class II cantilever implant exfoliation.

1Valen M and Locante WM: LaminOss^® Immediate-Load Implants: Part I - Introducing Osteocompression in Dentistry.
J Oral Implantology, 26(3):177-184,2000
2Block CM, Tillmanns HWS, Meffert RM, and Zablotsky MH: Histologic evaluation the LaminOss^® osteocompressive
dental screw: A pilot study. Compendium, 18(7):676-685, 1997
3 Otter MW, Palmieri VR, and Cochran GVB: Transcortical streaming potentials are generated by circulatory pressure gradients in living canine tibia. J Orthopaedic Restoration, 8:119-126, 1990
4 Salzstein RA and Pollack SR: Electromechanical potentials in cortical Bone-II. Experimental analysis.
J Biomechanics, 20(3):271-280, 1987

Learning Objectives:
1. Osteocompression and the benefits of electro-streaming potentials in bone restoration
2. Step-by-step surgery and prosthetic procedure for installing an immediate chairside implant-splinting system
3. Surgical technique to develop a physiologic implant interface by 2.5 times greater bone contact