Use of an Immediate Provisional Implant to Support a Full-Arch Interim Restoration: A Clinical Report

The use of provisional implants as the sole or adjunct mean of stabilization for interim fixed partial dentures has gained popularity in implant prosthodontic treatment. These implants can be used between submerged implants during the healing phase to provide support for interim fixed or removable partial dentures. In this clinical report, a provisional implant used to provide support for a full-arch fixed interim restoration is described. Positioned between adjacent conventional implants, the provisional implant was placed during the same surgical procedure. As a result, an immediate acrylic fixed partial denture supported by natural teeth and the provisional implant provided a comfortable and esthetic interim restoration during the osseointegration period.     

The use of healing abutments for the fabrication of cement-retained, implant-supported provisional prostheses

This article describes the intraoral preparation of healing abutments for use as prefabricated abutments for a cement-retained, implant-supported prosthesis. After the healing abutments are prepared, an impression is made with irreversible hydrocolloid, and the provisional restoration is fabricated indirectly. This technique is an easy and economical alternative for the fabrication of provisional fixed partial dentures or crowns but may be contraindicated for severely misaligned implants.     

Fabrication of an indirect-direct provisional fixed partial denture

This article describes a procedure for fabricating an optimal provisional restoration before tooth preparation. The procedure involves the fabrication of an indirect-direct provisional fixed partial denture. There are several advantages to this procedure, such as reduced chair time, less heat generated in the mouth, reduced contact between resin monomer and soft tissues, and optimal esthetics.     

Provisional implants for immediate restoration of partially edentulous jaws: a clinical study

PURPOSE: The aim of this study was to evaluate the use of provisional implants, which can provide patients with provisional fixed partial dentures during the healing time of augmentation procedures and/or during the osseointegration period of definitive implants until delivery of the definitive prosthesis. MATERIALS AND METHODS: Thirty-one patients were consecutively included in the study. Eighteen patients (group A, primary simultaneous group) were initially treated simultaneously with provisional and definitive implants and provided with 18 interim fixed partial dentures. Thirteen patients (group B) received provisional implants in a staggered procedure. In the first stage of group B patients (augmentation phase), provisional implants were placed to bridge the augmentation phase and for anchoring 13 interim fixed partial dentures. In the second stage (secondary simultaneous group), patients of group B received provisional implants to bridge the osseointegration phase for simultaneously placed definitive implants by further use of 13 interim fixed partial dentures. All patients were followed from provisional implant and definitive implant placement to delivery of the definitive prosthesis. Loss of provisional implants and interim fixed partial dentures was noted, and stability of provisional implants was evaluated using the Periotest device. The procedures of immediate rehabilitation with fixed partial dentures using provisional implants were subjectively rated by patients with regard to satisfaction, treatment period, and acceptance. RESULTS: In 31 patients, 44 provisional fixed partial dentures were supported by 98 provisional implants. No provisional implant loss in group A or group B-second stage was observed. Only 3 (3%) provisional implants were lost in group B-first stage during the augmentation phase. Incidence (90.8% versus 9.2%) and stability (Periotest values: 8.6 +/- 3.9 versus 4.8 +/- 2.7) of provisional implants differed significantly between maxilla and mandible (P < .01). All interim fixed partial dentures (n = 44) remained in place for the intended time period but in 3 cases with provisional implant loss they were shortened. No definitive implant loss (n = 94, survival: 100%) and especially no implant loss in cases of maxillary sinus augmentation was seen. The items rated showed high satisfaction and good acceptance of the intensive surgical and prosthodontic program. CONCLUSION: This clinical review showed that (1) provisional implants can successfully provide patients with a fixed partial denture for immediate rehabilitation to bridge the osseointegration or augmentation phase, even in cases with an initially compromised bone situation and (2) although treatment is elaborate, the selected patients decided on a fixed interim rehabilitation with provisional implants rather than on a removable solution.     

Chairside resin-based provisional restorative materials for fixed prosthodontics

Provisional restorations are vital to fixed prosthodontics treatment, providing an important diagnostic function while in place. In addition to protecting the prepared teeth, provisionalization enables clinicians to refine biologic and biomechanical issues before the final restoration is fabricated. Adjustments can be made in the provisional restoration to achieve both the clinician's and patient's desired results. The fabrication of temporary restorations requires that clinicians be proficient with a variety of materials and techniques that can be used to make well-adapted and functional provisionals. There are many material choices available to temporize a single crown as well as multi-unit fixed partial dentures, and the selection of provisional materials should be made based on a case-by-case evaluation. This article provides a review of polymeric resin provisional materials.     

Provisional restoration for abutment of an existing removable partial denture

The abutment of an existing removable partial denture may require a crown restoration. Fabrication of a provisional restoration to fit the existing clasp assembly requires special consideration. This article presents a simple technique for fabrication of such provisional restorations. An alginate impression is made of the arch with the removable partial denture in place. The abutment tooth is then prepared, providing adequate clearance between the clasp assembly and the tooth preparation. Cold curing acrylic resin of proper shade is mixed and poured in the impression of the abutment tooth. The impression is then seated in the mouth and removed before the acrylic resin is completely polymerized. The provisional restoration is then separated from the partial denture, finished and polished.     

Replacement of missing posterior teeth with an all-ceramic inlay-retained fixed partial denture: a case report

Adhesively luted all-ceramic inlay-retained fixed partial dentures can be a clinical alternative for the replacement of missing posterior teeth in certain situations. This type of restoration allows satisfactory esthetics and reduced tooth preparation compared to a conventional metal-ceramic fixed restoration. This case report describes the use of an inlay-retained fixed partial denture as a conservative alternative for the replacement of missing posterior teeth.     

A simplified approach to implant-supported metal-ceramic reconstruction

Restoring the edentulous patient with an implant-supported fixed complete denture prosthesis is a challenging procedure. The patient's occlusal vertical dimension, centric relation position, esthetics, and phonetics should be maintained throughout the restorative process, while the patient is traditionally wearing a removable prosthesis. This article presents an alternative treatment philosophy that addresses these concerns and guides the restorative process using a fixed provisional restoration made from the patient's removable complete dentures.     

Using a fixed provisional prosthesis during post-extraction healing and implant placement

Most dental patients insist on the use of provisional prostheses throughout healing and osseointegration when replacing extracted teeth with implants in esthetically sensitive areas. Removable appliances of some kind are normally used for this purpose, but patients often consider them to be too cumbersome. This can lead to decreased case acceptance and compliance with the use of the provisional restoration, which can compromise the final result of treatment. Custom fixed solutions to this problem exist, but they tend to be more complicated, less practical, and more expensive than other options now available. The Monodont bridge, a new system of prefabricated components for the creation of provisional fixed partial dentures, can be more esthetic, more retentive, more functional, more cost-effective, and more universally applicable than any other available techniques. This can raise patient tolerance of provisional prostheses and thus increase case acceptance, while fostering a more predictable esthetic result with regard to soft tissue contours and emergence profile.     

Transferring provisional restorations to final master casts

Many principles guide preparation and fitting of provisional restorations. Their importance as a diagnostic tool is considered. Aesthetic, phonetic, functional, parafunctional and dysfunctional factors after evaluation in the provisional restorations have to be transferred to the master cast to incorporate them into the final restoration. A method for transferring morphology of provisional restorations to the master cast through preparation of a wax analogue fixed partial denture is presented. This method is precise, practical, suitable for most rehabilitation cases, and not clinically time-consuming since most stages are carried out in the dental laboratory.     

Clinical performance and periodontal outcome of temporary crowns and fixed partial dentures: A randomized clinical trial

STATEMENT OF PROBLEM: Different materials (autopolymerizing, dual curing, and light initiated) are used for fabricating provisional restorations during prosthetic treatment. Randomized clinical trials that have evaluated these provisional materials have not been published. PURPOSE: This clinical trial compared the handling, fitting, plaque adherence, gingivitis, color stability, and the subjective assessment of the provisional materials by the patient and the dentist for 2 autopolymerizing (Protemp, Luxatemp), 1 dual-curing (Provipont), and 1 light-initiated (Triad-VLC) material for the manufacturing of temporary crowns and fixed partial dentures. MATERIAL AND METHODS: Thirty subjects in need of 2 similar fixed prosthetic restorations (single crowns ?20, three-quarter crowns ?2, connected crowns ?9, or fixed partial dentures ?30) were treated with 1 temporary restoration of Protemp II (control) and one randomly selected from Luxatemp, Provipont, or Triad-VLC materials. The mean time of treatment was 37.5 days (minimum 2 days, maximum 156 days). All restorations were manufactured intraorally with a vacuum-formed template. RESULTS: Mechanical and retentive characteristics revealed a high level of clinical reliability. Plaque adherence of the teeth with temporary restorations was significantly increased (P =.0039) compared with the untreated mesial reference teeth. CONCLUSION: The advantageous mechanical properties of the light-curing and dual-curing materials reviewed in dental literature were clinically offset by disadvantages in handling.     

Use of carbon-epoxy frameworks for reinforcing provisional fixed partial dentures

This article describes a technique for reinforcing provisional fixed partial dentures. Solid carbon-epoxy rods were shaped and coated with opaque resin to strengthen them for PMMA restorations of 3 or more units with at least 1 pontic. Because of the rigid nature of the prepolymerized carbon-epoxy material, only straight fixed partial dentures can be fabricated with this technique that allows for simplified fabrication of reinforced metal-free and cost-effective restorations.     

Direct and indirect fiber-reinforced fixed partial dentures: case reports.

Direct and indirect fiber-reinforced resin composite fixed partial dentures are a new way to produce minimally invasive, esthetic, and cost-effective metal-free tooth replacements. These treatment alternatives have a number of indications, for example, chairside tooth replacements, long-term provisional fixed partial dentures, economically feasible tooth replacements for patients who cannot afford more traditional treatment regimens, and tooth replacements for medically compromised patients who are unable to withstand the physical stress associated with fabrication of traditional fixed prostheses. This article presents four typical cases in which fiber-reinforced fixed partial dentures seemed to be the preferable treatment modality.     

Treatment of completely edentulous patients with fixed implant-supported restorations: three consecutive cases of simultaneous immediate loading in both maxilla and mandible

This article aims to: (1) describe the treatment of three consecutive completely edentulous patients with fixed implant-supported restorations, including simultaneous same-day immediate loading with fixed provisional restorations in both jaws; and (2) illustrate a step-by-step definitive restoration approach. All patients followed the same diagnostic protocol. One surgical intervention was performed for simultaneous implant placement in both maxilla and mandible. Following implant placement, all patients received a simultaneous, same-day, complete-arch, screw-retained provisional restoration in both jaws according to the "pickup" technique. After healing, final impressions were taken, and occlusion recorder devices were prepared on working casts. For the first occlusal record, the "half-provisionals" method was used. Definitive solid abutments were used for both laboratory and clinical procedures. After casting and finishing, the frameworks were tried in, and a new occlusal record was made. The definitive segmented restorations consisted of four fixed partial dentures in the maxilla and three in the mandible and were cemented with provisional cement. All patients received a nightguard. The pickup technique facilitated simultaneous immediate loading in both maxilla and mandible. A complete, fixed, segmented rehabilitation supported by six to eight anteroposterior implants is a reproducible treatment for completely edentulous patients when optimal anatomic conditions are present.     

Inlay fixed partial denture as a conservative approach for restoring posterior missing teeth: a clinical report

Inlay fixed partial dentures luted by use of adhesive procedures offer a clinical alternative for the restoration of single missing posterior teeth. The introduction of ceromers and fiber-reinforced composites and the continuous improvement of adhesive systems and luting agents make this type of restoration possible, offering good aesthetic and functional results. The procedure is minimally invasive and conservative. This clinical report reviews the factors influencing the diagnosis and the clinical indications for an inlay fixed partial denture. In addition, a patient treatment is presented to illustrate the clinical procedures involved.     

To place provisionals or not--that is the question

Porcelain labial veneers are quite possibly the most esthetic restorations that can be provided today. Their esthetic qualities are derived not only from the accurate replication of tooth structure, but also from the superior tissue response they elicit. Many of the procedures surrounding this restoration have become almost standardized in terms of preparation and the manner in which the restoration is made to become part of the tooth. But why experts who lecture about this procedure remain at odds about whether provisional restorations are necessary is baffling. As more tooth preparation became increasingly necessary to achieve the ultimate in esthetics and health, use of the provisional restoration was not incorporated, simply as a matter of established routine.     

A multifunctional, provisional, implant-retained fixed partial denture

This article describes the modification of a procedure for fabricating a laboratory-processed, metal-reinforced, acrylic resin provisional restoration that becomes an implant-retained fixed partial denture. The modification involves the incorporation of patrix and matrix components into a cast metal framework. The prosthesis can be used as an alternative to a removable radiologic stent and surgical guide. It can function as a surgical guide during implant placement and help retract the buccal mucogingival flap during implant placement. The prosthesis also can be used as an aid in locating the implant during stage II surgery. Finally, the pontics can be converted into an implant-supported provisional restoration immediately after the implant prosthetic components are attached to the uncovered implants.     

The implant-supported, heat-processed provisional fixed partial denture.

When fabricating an implant-supported fixed partial denture a provisional prosthesis is commonly required for function and esthetics. A laboratory-fabricated, heat-polymerized provisional restoration will provide excellent fit, function, esthetics, and durability while saving chair time. This article describes the clinical and laboratory procedures for the fabrication of the implant-supported, heat-processed provisional fixed partial denture.     

Immediate maxillary denture base extension for posterior palatal seal

A procedure for extension of the maxillary denture base for development of a posterior palatal seal is described. The technique involves provisional extension with paraffin wax and adding direct relining resin supported by a silicone putty core. This simple, quick procedure achieves immediate recovery of retention for underextended maxillary dentures without additional laboratory procedures.     

Use of an intra-pontic attachment as cosmetic support for a removable appliance

When using an introcoronal precision attachment in a combined Fixed and Removable Prosthodontic case, the retention and appearance can be greatly improved. When taking into consideration these advantages one must not forget the disadvantages and possible violation of the biological principles of tooth preparation. Because in order to obtain a restoration with adequate contours it is necessary to reduce a significant amount of tooth structure. In this case the attachment is used in a catelever pontic avoiding any excessive tooth reduction. In metal-ceramic restorations it is important that a glazed surface be achieved upon completion because it enhances material strength and reduces plaque retention. This clinical report presents a step-by-step procedure using an intra-pontic attachment as a retainer for a removable partial denture. The procedural sequence assures optimal marginal integrity and glazed porcelain surfaces upon completion. A post-solder technique is recommended to assemble multi-abutment metal ceramic fixed partial dentures.