provisional restorative options in implant

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Provisional restorative options in implant

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CONTENTS Introduction Definition Functions Requirements Classification Other methods of fabrication Using cad-cam Conclusion References

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Introduction

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DEFINITION According to The Glossary of Prosthodontic

Terms, A provisional prosthesis is a prosthesis

designed to enhance aesthetics, provide stabilization and/or function for a limited period of time, and should be replaced by a definitive prosthesis after a period of time.

04/12/2014Provisional restoration options in im

plant dentistry Australian Dental Journal 2007;52:(3):234-242

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FUNCTIONS Provisional restorations can be used as a

diagnostic restoration. Used to preserve the soft tissue morphology

around extraction socket . Guide the healing of the peri-implant tissue. Gives information about shade, crown & soft

tissue contours.



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It allows restoration of the integrity of the dental arch.

Occlusal stability of the opposing arch. Masticatory function. Proper speech and esthetics. Allows the patient to visualize and evaluate

the end restorative result.



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REQUIREMENTS It should be rigid and have sufficient strength

to with stand the occlusal forces. Provide ideal environment for healing. It should restore normal intra oral function. It should function as a template for the

esthetics It should not exert pressure on surgical site.



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Classification

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TYPE OF PROSTHESIS Removable Partial acrylic dentures Essix applianceFixed tooth supported Archwire supportedpontic Resin bonded pontic Resin bonded cast metal

framework bridgeFixed implant supported Transitional implants



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BASED ON THE TECHNIQUE

Chair side –direct technique Archwire supportedpontic. In laboratory- indirect technique. Resin bonded fixed partial

denture Both- direct & indirect. Essix appliance



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TIME OF CONSTRUCTION Prior to tooth extraction.

During socket healing.

Prior to implant placement.

During osseointegration.

After implant loading.



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BASED ON CONSTRUCTION

Pre-fabricated or Custommade

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Interim Removable Partial Denture

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An interim removable partial denture (RPD) is often used as a provisional restoration during the construction of an implant-supported prosthesis.



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Fixed and Removable Provisional Options for Patients

undergoing Implant Treatm

ent Compendium

Novem

ber 2007;28(11):604-609

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Essix appliance

04/12/2014ESSIX Appliances the Fabrication of a Tem

porary Bridge to Replace M

issing Anterior Teeth ELLIOTT M. M

OSKOWITZ, JOHN J.

SHERIDAN, KRUNO TOVILO. Virtual Journal of Orthodontics

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The Essix provisional is made from clear thermoplastic sheets to retain pontics for missing teeth.

The pontic is fabricated by applying the vacuum form sheet under high pressure and heat over the denture teeth




OSKOWITZ, JOHN J. SHERIDAN,

KRUNO TOVILO. Virtual Journal of Orthodontics

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TECHNIQUE 04/12/2014

ESSIX Appliances the Fabrication of a Temporary Bridge to Replace

Missing Anterior Teeth ELLIOTT M

. MOSKOW

ITZ, JOHN J. SHERIDAN, KRUNO TOVILO. Virtual Journal of Orthodontics

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OSKOWITZ, JOHN J. SHERIDAN,

KRUNO TOVILO. Virtual Journal of Orthodontics

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Fixed provisional prosthesis

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Fixed provisional prostheses include Bonded extracted natural teeth, denture teeth, and cast metal reinforced Resin bonded fixed partial dentures



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Type 1 bonded denture teeth with stainless steel wire

Fixed and Removable Provisional Options for Patients

undergoing Implant Treatm

ent Compendium

Novem

ber 2007;28(11):604-609

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Staged extraction and implant placement approach

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Pre-operative radiograph. The patient had generalized refractory periodontitis, especially in the maxillary arch.

Pre-operative facial view. One of the patient’s chief complaint was the anterior crowding and the vertical drifting of maxillaryanterior teeth.



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Diagnostic wax up of the planned restoration illustrating anticipated contours of the final restoration. The alignment of anterior teeth was altered to provide straighter, more aesthetically pleasing teeth. The incisal lengths of maxillary incisors were reduced, decreasing the horizontal and vertical relationship of the anterior teeth.

Facial view of prepared teeth immediately after extraction. Strategic teeth were maintained to retain the provisional prosthesis. The implant sites were previously selected and the non-strategic teeth were removed according to the diagnostic wax up.



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Provisional acrylic restoration prior to insertion. The provisional restoration is relined with compatible self cure resin to fit over the prepared abutment teeth.

Fixed provisional restorations cemented on strategic natural abutments. The molars have been retained temporarily to maintain the vertical dimension of occlusion.



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Natural tooth as provisional

04/12/2014Natural crown vs im

mediate im

plant FARHAN DURANNI, ijoicr jan-apr 2014;5(1):34-37

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mediate im


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mediate im


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mediate im


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Transitional implant provisional restorations



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In extended partial edentulous areas where there are no or limited natural abutments to support a provisional restoration, one or more transitional implants may be used.

These transitional implants are loaded immediately to support the provisional restoration



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Immediate provisional implants were placed and strategic teeth were maintained to support long-term telescopic provisional restoration. The 14-year-old patient requested a long-term fixed provisional restoration until the definitive implants are placed.



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Post-implant placement



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Implant retained provisional restorations

Provisional restorations may be used at the time of implant placement or after an appropriate healing period.



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The term “immediate restoration” is used when a prosthesis is fixed to the implants within 48 hours without achieving full occlusal contact with the opposing dentition.

whereas “immediate loading” is when the prosthesis is fixed to the implants in occlusion within 48 hours.



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Hybrid prosthesis



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Patient’s existing complete mandibular denture was modified to accommodate temporary cylinders on the implants. A duplicate of the denture was used as radiographic and surgical guide for the planning and surgical phase of the treatment. The three dimensional positions of the implants were determined from the diagnostic wax up and clinical and radiographic examination.

Try in of the mandibular denture over the temporary cylinders.



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Self cure resin was used to attach the denture and the temporary cylinders. The denture flange was then trimmed and the fitting surface was adjusted to allow proper hygiene.

The provisional hybrid was used as verification jig over the master cast. The soft tissue moulage was removed to verify the fit of the provisional on the subgingival implant restorative margins



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The same provisional hybrid was articulated with a biteregistration material, against the previously articulated study cast

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Provisional restoration options in implant dentistry Australian Dental Journal 2007;52:(3):234-242

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Cement retained provisionals



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A cement on, prefabricated abutment was torqued to the recommended value, six weeks post-placement. The abutment Was chosen to allow adequate space for crown construction within the available interocclusal space.

A denture tooth with appropriate shade and shape was selected to fit the edentulous space. The acrylic tooth was then hollowed out to fit over a practice implant analog and abutment extra-orally.



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The denture tooth was relined intra-orally using self cured acrylic resin to capture the indexing component of the abutment.

The relined denture tooth was fitted over the practice implant extra-orally. Note on the deficiency from the implant margin to the acrylic tooth due to tissue impingement.



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The deficiency was filled in and the excess material trimmed to the appropriate emergence profile.

The provisional crown was cemented with provisional cement.



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A temporary meso abutment, one piece temporary abutmentfits directly into the implant body. The abutment is made of PEEK(Polyetheretherketone) plastic and titanium inlay.

Unaltered temporary meso abutment on the soft tissue working cast. The abutment can be prepared in the laboratory or chair side with altered cement margin and corrections of anyangulation problems.



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Screw retained provisional



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A screw retained provisional crown was made at chairside from the patient’s existing partial denture, attached to the temporary cylinder using additional self cure resin. The excess temporary cylinder is reduced to follow the palatal contour of the existing partial denture and patient’s occlusion.

Facial view of screw retained provisional restoration on tooth 11 site. The provisional restoration was hand tightened.



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Other types of fabrications

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Customized provisional abutment and provisional restoration for an immediately-placed implant

Preoperative appearance of patient demonstrated short clinical crowns and a discolored, uneven appearance of the dentition.

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ized provisional abutment and provisional

restoration for an imm

ediately-placed implant, GERARD

J. LEMONGELLO, JR, DM

D, Pract Proced Aesthet Dent 2007;19(7):419-424.

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04/12/2014Custom

ized provisional abutment and provisional restoration

for an imm

ediately-placed implant, GERARD J. LEM

ONGELLO, JR, DM


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04/12/2014Custom


for an imm


ONGELLO, JR, DM


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04/12/2014Custom


for an imm


ONGELLO, JR, DM


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04/12/2014Custom


for an imm


ONGELLO, JR, DM


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04/12/2014Custom


for an imm


ONGELLO, JR, DM


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Chair side provisional restoration utilizing acrylic shells and alginate impressions

04/12/2014Application and fabrication of chair side provisional restorations utilizing acrylic shells and alginate im

pressions, STUART J FROUM

, SANG CHOON CHO, TAKANORI SUZUKI

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Application and fabrication of chair side provisional restorations utilizing acrylic shells and alginate im



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04/12/2014

Application and fabrication of chair side provisional restorations utilizing acrylic shells and alginate im

pressions, STUART J FROUM, SANG CHOON CHO,

TAKANORI SUZUKI

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pressions, STUART J FROUM, SANG CHOON CHO,

TAKANORI SUZUKI

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DIGITAL DESIGN PROCEDURE

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DIGITAL DESIGN STRATEGY04/12/2014

Rapid manufacturing of dental prostheses by m

eans of selective laser sintering/m

elting, J.-P. KRUTH1, B. VANDENBROUCKE, J. VAN VAERENBERGH1, I. NAERT

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CAD-CAM implant restoration

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mediately loaded full-arch provisional im

plant restorations using CAD/CAM

and guided placement: m

axillary and mandibular case

reports S. R. ALLUM, British dental journal volum

e 204 no. 7 apr 12 2008

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04/12/2014Im




axillary and m

andibular case reports S. R. ALLUM, British dental journal

volume 204 no. 7 apr 12 2008

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04/12/2014

Imm

ediately loaded full-arch provisional implant restorations

using CAD/CAM and guided placem

ent: maxillary and

mandibular case reports S. R. ALLUM

, British dental journal volum

e 204 no. 7 apr 12 2008

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04/12/2014

Imm

ediately loaded full-arch provisional implant restorations using

CAD/CAM and guided placem

ent: maxillary and m

andibular case reports S. R. ALLUM

, British dental journal volume 204 no. 7 apr 12

2008

Long guide screws have been fitted on the two central implants and the temporary bridge seated intra-orally on its prosthetic carrier. The proper positioning of the guide screws (centrally through the bridge abutment openings) confirms that both the surgical and prosthetic stages have been accurately executed.

The four temporary cylinders have been tacked into position in the mouth. The bridge has been removed for final chair side acrylic additions and finishing.

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axillary and mandibular case

reports S. R. ALLUM, British dental journal volum

e 204 no. 7 apr 12 2008

Final view on completion

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CONCLUSION

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Provisional restoration options in implant dentistry Australian Dental Journal 2007;52:(3):234-242

Fixed and Removable Provisional Options for Patients undergoing Implant Treatment Compendium November 2007;28(11):604-609

Immediately loaded full-arch provisional implant restorations using CAD/CAM and guided placement: maxillary and mandibular case reports S. R. ALLUM, British dental journal volume 204 no. 7 apr 12 2008

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Customized provisional abutment and provisional restoration for an immediately-placed implant, GERARD J. LEMONGELLO, JR, DMD, Pract Proced Aesthet Dent 2007;19(7):419-424.

Provisional Restoration for an Osseointegrated Single Maxillary Anterior Implant, ROBERT DAVID, DDS, JCDA September 2008, Vol. 74, No. 7.

ESSIX Appliances the Fabrication of a Temporary Bridge to Replace Missing Anterior Teeth ELLIOTT M. MOSKOWITZ, JOHN J. SHERIDAN, KRUNO TOVILO. Virtual Journal of Orthodontics

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Application and fabrication of chair side provisional restorations utilizing acrylic shells and alginate impressions, STUART J FROUM, SANG CHOON CHO, TAKANORI SUZUKI.

Natural crown vs immediate implant FARHAN DURANNI, ijoicr jan-apr 2014;5(1):34-37.

Rapid manufacturing of dental prostheses by means of selective laser sintering/melting, J.-P. KRUTH1, B. VANDENBROUCKE, J. VAN VAERENBERGH1, I. NAERT.

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provisional restorative options in implant

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