Single-tooth implants in the esthetic zone usually require the use of a provisional restoration The fabrication of a single-tooth implant supported restoration requires careful step-by-step approach in order to deliver a restoration that will assist the process of soft tissue sculpting.

Fig 1. Clinical situation prior to making the impression for provisional fabrication:

provisional

Fig 2. Impression coping is secured into the implant and ready for radiographic verification:

sti provisional

Fig 3: An impression utilizing polyvinylsiloxane is made and an implant replica is secured onto the implant. Soft tissue moulage is carefully injected around the analog:

single tooth implant

 Fig 4. A master cast is obtained by securing an analog into the impression coping in the impression and pouring it with stone and a soft tissue moulage in the area of the implant:

single tooth implant fabrication

Fig 5.  A temporary titanium abutment is secured and the height is customized:

single tooth implant

Fig 6. A full contour wax up is made on top of the abutment

implant provisional

Fig 7.  A silicone matrix is made from the wax-up:

sti provisional

Fig 8. The temporary abutment is opaqued and inserted back in place:

single tooth implant

Fig 9. Acrylic resin is injected into the silicone matrix and is seated on the cast to then obtain the full contoured provisional:

Fig 10. Contour is added at the emergence profile area in order to influence the sculpting of the tissue. It is then polished utilizing a silicone wheel.

Fig 11.  The finalized single-tooth implant-supported screw-retained provisional restoration:

Fig 12.  Facial aspect of the provisional in place, still waiting for soft tissue maturing of the mesial papilla:  

Fig 13: An occlusal view of the screw-retained provisional restoration.

A multi-step process has been shown, walking the reader through the fabrication sequence of a screw-retained single-tooth implant provisional restoration of a lateral incisor.

(Click this link for more dentistry articles by Dr. Ricardo Mitrani.)

Ricardo Mitrani, D.D.S., M.S.D., Spear Faculty and Contributing Author

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