Provisionalization

Question 1

What are 4 reasons to provisionalize?

Answer 1

1. Esthetics
2. Function
3. Soft tissue management
4. Patient request

Question 2

What are 2 things a provisional can do for soft tissue?

Answer 2

1. Maintain soft tissue cuff of implant

2. Evaluate soft tissue response

Question 3

What are 7 methods of implant provisionalization immediately following implant placement?

Answer 3

1. Healing abutment
2. Essix
3. Interim RPD
4. Complete denture
5. Immediate provisional
6. Bonded natural tooth
7. Bonded FPD

Question 4

Which bonds better in an essix, Polymethylmethacrylate(PMMA) or Bis-acryl (Integrity)?

Answer 4

PMMA

Question 5

What should you tell patient if the Essix is going to be a long term provisional?

Answer 5

They will probably need to wear two during the course of their healing

Question 6

What must you have if what to use a provisional resin bonded tooth (tooth with resin wings)?

Answer 6

Occlusal room on linguals of abutment tooth to bond on the wings

Question 7

What are 5 benefits of fixed implant provisionals?

Answer 7

1. Provides esthetics
2. Stabilizes occlusion
3. Helps to promote good soft tissue contours
4. Psychological boost for patientt
5. Provides info for definitive restoration

Question 8

What are 5 times in the implant treatment when a fixed implant level provisional can be made?

Answer 8

1. Immediately following surgery Index implant at time of surgery
2. After uncover implant
3. At 2nd stage surgery
4. Indirect from master cast made after complete healing and osseointegration
5. Directly in pt’s mouth after complete healing and osseointegration

Question 9

If you immediately implant-level provisionalize an implant at time of placement, what must be done?

Answer 9

Do not load it, take it out of occlusion to avoid micromovement

Question 10

When you index the implant at time of surgery, what can be used?

Answer 10

Modified surgical guide is put around the surgical fixture and you mount the analogue, cover it with impression material, then the lab fabricates it

Question 11

What is a problem with direct implant level provisionalization?

Answer 11

Not efficient for multiple units, more chemicals in pt’s mouth

Question 12

What is a benefit of indirect implant level provisionalization?

Answer 12

Easier for larger cases, may save chair time in long run, easier to handle materials

Question 13

What are 2 types of provisional copings?

Answer 13

Metal and plastic

Question 14

What is the PEEK plastic provisional coping and where is it best used?

Answer 14

Polyether ether ketone, used in anterior so won’t show thorugh provisional

Question 15

What materials can be used on the PEEK plastic provisional coping?

Answer 15

1. Polycarbonate crown
2. Methylmethacrylate (Jet, Alike)
3. Bis-acryl (protemp plus, Luxatemp, Integrity)

Question 16

What is a benefit of a screw retained provisional?

Answer 16

No subgingival cement risk and manage subgingival contours

Question 17

What is a concern with a cement retained provisional?

Answer 17

Subgingival cement

Question 18

Palaseal and Luxaglaze are both what?

Answer 18

Unfilled resins that just shine up facial of provisional

Question 19

Fermit is what?

Answer 19

Composite that stays soft, covers the cotton ball over the fixture screw

Question 20

What bur should be used to remove the provisional composite plug?

Answer 20

4 or #6 round bur in high speed

Question 21

What is used to remove cotton pellet from a provisional plug?

Answer 21

Hand instrument (spoon or explorer or large barbed broach if pellet packed inthere)