8/30 - Provisionals During Implant Healing

Question 1

are provisionals arranged or existing for the present with the possibility to be changed later

Answer 1

YES

Question 2

what is the objective of provisionals

Answer 2

esthetic and functional replacement of missing tooth structure or teeth fora limited period of time

Question 3

what are the provisional options during healing

Answer 3

1. essix retainer
2. interim removable partial denture
3. fixed tooth-supported provisional
4. implant provisional

Question 4

when are essix retainers intended for use

Answer 4

initial post-surgical phase

Question 5

how many weeks to use essix

Answer 5

</= 3 weeks

Question 6

are essix retainers tooth borne

Answer 6

yes

Question 7

advantages of essix retainer

Answer 7

1. no pressure on tissue during initial healing
2. inexpensive and quick fabrication

Question 8

disadvantages of essix retainer

Answer 8

1. short-term
2. esthetics only - not functional so should be not eat with it
3. removable

Question 9

what vacuuform material for essix

Answer 9

0.040”

Question 10

when preparing the essix for scalloping, what do you mark

Answer 10

cervical aspect of CEJ

Question 11

is it better to destroy cast or distort vacuum material

Answer 11

destroy cast

Question 12

steps for cuttting essix

Answer 12

1. acrylic bur
2. scotch brite
3. felt wheel

Question 13

where to place coe-sep

Answer 13

in area of composite tooth of stone model

Question 14

is it ok if there is space between cast and composite? why?

Answer 14

yes because that is where tissue fills in

Question 15

what to tell pt when delivering essix retainer

Answer 15

1. where for esthetics only
2. no eating with it on
3. brush before inserting again because that’s where bacteria harbors

Question 16

what is know to patients as flipper

Answer 16

interim partial denture

Question 17

materials in interim partial denture

Answer 17

acrylic, denture teeth, wrought wire clasps

Question 18

what are interim partial dentures intended for

Answer 18

post-surgical phase after initial healing

Question 19

how long can interim partial denture last

Answer 19

> /= 3 weeks-yearsa

Question 20

advantages of interims

Answer 20

1. esthetic and functional
2. space maintenance
3. inexpensive and quick fabrication
4. repairable

Question 21

disadvantages of interims

Answer 21

1. pressure on surrounding hard and soft tissues and surgical site
2. removable

Question 22

when are fixed tooth-supported provisionals indicated

Answer 22

in situations when adjacent tooth/teeth will have definitive full coverage restorations

Question 23

are fixed tooth supported materials tooth born

Answer 23

yes

Question 24

what materials can be used for fixed tooth supported provisional

Answer 24

acrylic (Jet or Trim)
Bis-acryl (Integrity)

Question 25

are fixed tooth-supported provisionals intended for post surgical healing

Answer 25

yes

Question 26

advantages of fixed tooth supported provisionals

Answer 26

1. no pressure on tissue during initial healing 2. fixed 3. esthetic 4. tissue sculpting (around area of pontix)

Question 27

disadvantages of tooth-supported provisional

Answer 27

1. maintenance/fracture/debonding 2. caries risk

Question 28

are implant provisionals tooth borne?

Answer 28

NO! implant-borne!

Question 29

materials of implant provisional

Answer 29

1. plastic or titanium temporary abutment 2. acrylic 3. bis-acryl 4. composite 5. denture tooth

Question 30

advantages of implant provisional

Answer 30

1. fixed 2. tissue support 3. identity implant and/or angulation problems

Question 31

disadvantages of implant provisional

Answer 31

1. esthetic challenges 2. no removal during healing 3. implant vulnerability 4. no functional contribution (all above are immediate/early) 5. increased cost

Question 32

what are implant provisionals intended for

Answer 32

1. post surgical healing 2. soft tissue development 3. patient management 4. predict prosthetic form/contour 5. identify implant angulation problems 6. evaluate questionable implants

Question 33

different levels of implant provisional protocols

Answer 33

1. immediate 2. early 3. conventional/delayed

Question 34

when level: implants placed within 1 week of placement

Answer 34

immediate

Question 35

what level: implant in function between 1 week and 2 months after placement

Answer 35

early

Question 36

what level: plant in function after 2 months healing

Answer 36

conventional/delayed

Question 37

immediate implant provisionals are used only in what situations

Answer 37

1. adequate primary stability 2. no centric, eccentric, or protrusive contacts 3. esthetic gain outweighs risks associated w/ immediate loading protocols

Question 38

what is the initial fixation of implnt sufficiently strong to withstand disloding forces

Answer 38

primary stability

Question 39

where is primary stability mechanical in nature

Answer 39

1. osteotomy 2. bone density 3. implant geometry 4. thread pattern

Question 40

does a more or less aggressive thread pattern bind more tightly to bone

Answer 40

more

Question 41

what is the minimum insertion torque for primary stability? what is preferred

Answer 41

minimum: 30-35 Ncm preferred: 40-45 Ncm

Question 42

what test uses a meter and probe placed on implant to see how tight it is on bone

Answer 42

ISQ test Implant Stability Quotient

Question 43

are we always able to do an immediate implant provisional

Answer 43

NO

Question 44

when can you not do implant provisional

Answer 44

1. lack primary stability 2. parafunctional habits 3. unable to eliminate centric/eccentric/protrusive contacts 4. non-compliant patient 5. non-esthetic zone 6. esthetic gain deos not outweight risk of implant complications

Question 45

provisional prostheses should be ___, ___, and ___ to last throughout the duration of tx

Answer 45

strong, durable, and esthetic

Question 46

in clinic, when working on ANTERIOR CASE, implant tx plans should include what?

Answer 46

1. essix retainer (/= 3 weeks- second stage) 3. interim abutment (2nd stage-definitive restoration placement aka provisional implant crown)

Question 47

after patient signs implant treatment plan, what codes are moved to COMPLETE

Answer 47

1. surgical guide 2. treatment plan

Question 48

after patient signs implant treatment plan, what codes are moved to IN PROCESS

Answer 48

1. essix retainer 2. interim partial denture

Question 49

prior to surgery appointment what must be done

Answer 49

1. create essix retainer and wax up 2. create interim partial denture

Question 50

when drawing design for interim partial denture, what color is acrylic and what color is wrought wire

Answer 50

acrylic = red wrought wire = blue

Question 51

when creating interim partial denture, how do you denote on a cast that a tooth is to be extracted

Answer 51

"x" on tooth

Question 52

what to do on day of implant surgery

Answer 52

1. deliver essix retainer 2. index implants for provisional implant crown fabrication

Question 53

on the day of implant surgery, when can you index implants for provisional implant crown fabrication?

Answer 53

as long as implant is stable

Question 54

on day of implant surgery, when codes to you place in COMPLETE

Answer 54

surgical codes and essix retainer

Question 55

on day of implant surgery, when codes to you place in IN PROCESS

Answer 55

interim abutment

Question 56

when completing records/ note on day of surgery what must you do

Answer 56

be specific of the implant diameter and length placed e.g., 4.8x11 S and 4.811P are very different and affect how they are restored