Fixed Provisional Restoration for Multiple Teeth Post Implant Placement: Your Suggestions?

1.To create a provisional restoration for the totally edentulous patient, use the existing denture. Be sure to adjust and reline the denture. 2.For the partially edentulous patient – after implant insertion, use suitable conventional temporization procedures.(acrylic crown /bridge) 3.(Temporary components available in Noble biocare,biohorizon .... )Temporary abutments and temporary copings placed on permanent abutments are available for use with a provisional restoration(immediate function/ screw retained /cement retained).

1. Make diagnostic model before placing implants 2. Make wax up and matrix (you may take silicone impression from waxup teeth) 3. Place implants. 4. Screw up temporary abutments (in some systems i use implant transfer as temporary abutment (Ankylos, Semados) or plastic caps (Xive ....) 5. Use matrix to make temporary, avoid use of cement. Just place acrylic material and wait. Remove excess of temporary material with diamod burs. Polish. Occlusion check. Leave it for 1 month. Depending of system there will be always possibility to remove them - provisionals must be "screw retained". This works if you have at least 3 implants with instertion torque 30-50 Ncm. In other cases you must avoid any temporarization on implants and you may only use neibourght teeth. I suggest to use insertion transfers as temporary abutments.

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Any views on using the neighboring teeth for temporary restorations. In case if there are two teeth missing and a provisional has to be given using adjacent teeth which are non diseased and in good state, what do you recommend?

temporary prosthesis is needed either for esthetic reason and guidance anterior area or for keeping occlusion posterior area.for both you well use acrylic RPD and the timing is different for anterior one you can use it after 2 days and remission of soft tissue edema, posterior one I prefer to post pone it for two weeks with diet instruction. another way is to use mini implant for temp. prosthesis

In cases we do bone grafts RPD is contraindicated. How do you temporarily restore such cases.

If this patient was missing all of their teeth and the surgery involved grafting, sinus lifts or if insertion torque values were less than 50ncms, I would have them prepare to stay out of the "public venue" for two months, at least. Some of these patients proceed with normal activities. This is a small price to pay, to assure greater long term success. We are replacing missing body parts, early loading is foolish, in most big cases. Bv