By Edward Goldin, DDS
In today’s state of implant dentistry, simply achieving osseointegration and creating a functional restoration is not enough. Patients have come to expect highly esthetic results regardless of whether or not we are restoring teeth or implants. In the early days of implants, putting the words “esthetic” and “implants” in the same sentence might get you laughed off the podium. Today, it’s hard to find a lecture that doesn’t contain these two words together; times have changed.
Fortunately, the tools for achieving good implant esthetics are really no different from those necessary to achieve good esthetics on natural teeth. All the rules of provisionalization apply:
- Develop proper emergence profile.
- Establish proper tooth form.
- Establish proper occlusal scheme.
- Use materials that will support optimal soft-tissue healing. (This is the key to implant esthetics.)
Optimal soft-tissue healing around provisional restorations on teethWhen it comes to implant provisionalization and final restorations, I prefer screw-retained restorations. This does require that implant placement is such that access is through the central fossa of posterior teeth and the cingulum of anterior teeth. Anything near the incisal edge will require either an angulated abutment or a cementable restoration. It’s true that screw-retained restorations do require a little more patience, but it will pay off in spades once you do a few.Here are a few easy steps to make a screw-retained implant provisional restoration that will set the stage for your final crown. This can be done in the mouth for immediate loading situations or after implant uncovering. These techniques can also be done on the bench top after an implant level impression and then delivered to the mouth.1. Place the screw-retained implant cylinder on the implant using the abutment screw.
