Stage 3(2 weeks preoperative) – Custom-made subperiosteal implants manufacturing
The implants were manufactured by a direct metal laser sintering using EOSINT M 280 machine. It specifically produces top-quality metal parts on the premise of three-dimensional CAD information – completely naturally, in only a couple of hours, and with no require for other devices (4).
The system is alternatively prepared with a strong state laser of either 200 or 400 watts. This laser gives an outstandingly highquality radiation and stable execution. The Laser Power Monitoring (LPM) makes it conceivable to control all this during the building process. Beside an optimized Gas Management System this ensures ideal and steady handling conditions for highest and consistent part building qualities. The system works in both protective nitrogen and argon environments. This allows the system to process a wide range of materials: from light metals to stainless and tooling steel to super alloys. The plates were polished on the surface that contacts soft tissue. The surface that contacts bone was left rough (4).
To ensure a very smooth process of the surgical stage and to provide the clinician with all the necessary tools, the implants were delivered by the manufacturing company within a complete box full of the needed accessories for our procedure [Fig. 9(a)] (9):
1) a 3D printed polymer model useful for the clinician to establish the outline of the flap elevation which must be 3 – 4 mm away from the outline of the implant design;
2) sterilized 3D printed implant;
3) fixation screw driver with handle and fixation screws;
4) healing caps;
5) prosthetic components for overdenture restoration/prosthetic components for screw retained restoration as transfer abutments, connection abutments, analogs;
6) demineralized bone matrix ready to use withourt hydration or mixing;