Provisionalization

Question 1

Implant Provisionalization: Advantages

Answer 1

• restore esthetics & function
• extended period of use (Bone graft)
• patient exerpience prosthesis before final restoration (expensive)

Question 2

What are the provisionalization options before implant healing?

Answer 2

• Fixed Provisionals
  
  • Bonded bridge
    
    • “Ribbond or Everstick”
  • Temporary Fixed Bridge
  • Immediate Implant provisionalization
  • Temporary Implant retained provisional
• Removable Provisionals:
  
  • Removable Partial Denture (RPD Flipper)
  • Complete denture
  • Essix retainer

Question 3

Fixed Provisionals vs Removable Provisionals

Answer 3

• Fixed:
  
  • more comfortable
  • well tolerated
  • show how final prosthesis will look and feel
  • less bulky
• Removable
  
  • Remove at night
  • Bulkier

Question 4

Bonded bridge:

General Info

Advantages vs disadvantages

Answer 4

• Framework=Ribbond (Fiberglass) or Everstick
• Advantages:
  
  • No transmucosal loading
• Disadvantages:
  
  • Can’t replace >1 anterior tooth
  • Can’t use In:
    
    • Deep Bite
    • crowned adjacent teeth

Question 5

Temporary Fixed Bridge:

General Info

Advantages vs disadvantages

Answer 5

• aka Tooth Supported Temporary Bridge
• Advantages:
  
  • No Transmucosal loading
  • More resistant to dislodgment
• Disadvantages
  
  • Have to prep adjacent teeth
  • Prepped teeth cannot be finalized until the implant is ready to be restored

Question 6

Immediate Implant Provisionalization:

General Info

Advantages vs disadvantages

Answer 6

• Provisional placed immediately after implant placement
  
  • take tooth and hollow out→use as shell
• Keep out of occlusion
• can’t use w/parafunctional habits

Question 7

Temporary Implant retained provisional:

General Info

Advantages vs disadvantages

Answer 7

• Fixed Provisional
  
  • Mini Implants=Temporary Implants
    
    • holds temporary prosthesis
    • don’t osseointegrate→ Easily Removed
• Advantages:
  
  • takes the load off definitive implants
• Disadvantages:
  
  • added expense
  • High stress area=Fracture

Question 8

Removable Partial or Complete Denture

General Info

Advantages vs disadvantages

Answer 8

• Removable Provisoinal
  
  • tissue supported
• Advantages:
  
  • cheap
  • convert to fixed temporary after implants are healed
  • if satisfactory=index for final prosthesis
• Disadvantages:
  
  • Transmucosal loading
  • Bulky
  • Psychological trauma

Question 9

Essix Retainer:

General Info

Advantages vs disadvantages

Answer 9

• teeth supported
  
  • No Transmucosal Loading
• Disadvantages:
  
  • Breaks easily
  • Altered speech at beginning
  • Don’t use when eating

Question 10

What are the provisionals used after implant Healing?

Answer 10

• Cement Retained Provisional
• Screw Retained Provisional

Question 11

Cement Retained Provisonal:

General Info

Advantages vs disadvantages

Answer 11

• Temporary Abutment
• Plastic Gasket “Coping”
• Advantages:
  
  • More esthetic
• Disadvantage:
  
  • can’t use with Short Abutment
    
    • limited inter arch space
  • Excess cement in sulcus

Question 12

Screw retained Provisional:

General Info

Advantages vs disadvantages

Answer 12

• No Abutment
• Advantages:
  
  • Better for Limited Interarch space
• Disadvantages:
  
  • No Angled Implants=Facial access hole