Treatment planning: the provisional phase
One critical challenge of implant therapy is the provisional phase. Most patients want a temporary replacement of missing teeth during the period between implant placement and final prosthetic restoration, in particular in esthetic areas. Temporary solutions may be of three types: removable, tooth supported or implant supported. Their role is to preserve esthetics and function, and to prevent tooth migration. In non-esthetic areas and for particularly risky procedures (bone grafts, barrier membranes), clinicians may decide not to place any provisional restoration.
The decision to use a temporary replacement and the choice of restoration type should be determined during treatment planning. The restoration can be elaborated chairside or in the laboratory. The provisional prosthesis can be elaborated at different steps of the treatment: prior to extraction, before implant placement, after implant placement or after implant osseointegration.
The Role of the Temporary Prosthetic Restoration
As in conventional dentistry, the temporary prosthetic restoration in implant dentistry plays a major role during the entire treatment. It maintains esthetics and provides stabilization and function.
In the esthetic area the provisional restoration is used to maintain soft tissue morphology after tooth extraction and to guide soft tissue healing for the final restoration (see Chapter 26, Fig. 26.3). It is a preview of the future restoration on which all modifications can be tested with the patient and the laboratory.
General Specifications of Temporary Prosthetic Restorations
- Not traumatic to adjacent teeth and soft tissues
- No negative interference with osseointegration
- Easy to modify if necessary
- Acceptable esthetics
- Easy to clean
- Strong and durable for the duration of the treatment
- Low financial cost
A temporary partial denture is an inexpensive, simple to elaborate, easy to remove and easily revisable solution. However, a denture may be unstable and compressive on the mucosa, causing indirect loading, marginal bone loss and even loss of osseointegration. This drawback can be particularly obvious with grafted sites.
The denture should be modified for the first weeks, to avoid any/>