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Provisional restoration options in implant dentistr

Article in Australian Dental Journal · October 2007

DOI: 10.1111/j.1834-7819.2007.tb00494.x · Source: PubMed

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 CLINICAL REPORT
Australian Dental Journal 2007;52:(3):234-242

Provisional restoration options in implant dentistry

RE Santosa*

Abstract healing period, patients may have to wear a removable

Unlike their use in conventional crown and bridge, provisional prosthesis prior to delivery of the final
provisional restorations during implant therapy have prosthesis, especially in the aesthetic zone. In the non-
been underutilized. Provisional restorations should aesthetic zone, clinicians may decide not to construct
be used to evaluate aesthetic, phonetic and occlusal provisional restorations.
function prior to delivery of the final implant In some cases, patients are able to have a provisional
restorations, while preserving and/or enhancing the
condition of the peri-implant and gingival tissues. restoration constructed after the treatment planning
Provisional restorations are useful as a phase and delivered as early as the day of implant
communication tool between members of the placement.4 However, in restorative driven implant
treatment team which, in most cases, consists of the placement,5,6 hard and soft tissue augmentation is
restorative clinician, implant surgeons, laboratory routinely performed to optimize the implant site prior
technicians, and the patient. This article describes to surgery, effectively extending the treatment time.
and discusses the various options for
provisionalization in implant dentistry. Clinicians Any provisional prostheses would then need to be
should be aware of the different types of provisional strong, durable and aesthetic to last throughout the
restorations and the indications for their use when duration of the treatment. A traditional provisional
planning implant retained restorations. prosthesis may consist of an existing or newly
Key words: Provisional restorations, dental implant, constructed removable provisional denture which can
custom impression. be utilized until delivery of the final prosthesis.
(Accepted for publication 27 April 2007.) However, removable provisional prostheses may place
undesirable pressure upon these graft sites, hampering
the healing process.4,7,8 Therefore, provisional
INTRODUCTION restorations that are fixed to the adjacent teeth or that
Implant supported restorations for partially and fully completely eliminate the possibility for soft tissue
edentulous patients are a well-accepted and predictable contact may be more beneficial for implant integration
treatment modality. Success rate of implant retained and soft tissue maintenance. Tooth borne or fixed
prostheses for complete and partial edentulism has provisional restorations may also satisfy patients’
been shown to be over 90 per cent.1-3 With the increase aesthetic, functional and psychological demands. One
in treatment acceptance for dental implants, both of our roles as clinicians is to provide functional and
patients and clinicians have greater expectations aesthetic provisional restorations that allow for the
towards implant therapy. Patients facing loss of their smooth transition of patients from natural dentition to
teeth may experience apprehension towards losing their implant based restorations.8,9
social image or daily function. Hence, patients often
expect to have their implants loaded with some type of Function of provisional restorations
fixed prosthesis similar to their natural dentition much According to The Glossary of Prosthodontic Terms,10
earlier. Clinicians also expect their restorations to be a provisional prosthesis is a prosthesis designed to
functional, aesthetic, and in harmony with the enhance aesthetics, provide stabilization and/or function
surrounding hard and soft tissues. Today, implant for a limited period of time, and should be replaced by
integration is given with the greater knowledge of the a definitive prosthesis after a period of time.
biological basis for treatment and improvements
In restoration-driven implant placement,5,6 implants
primarily associated with implant morphology.
are positioned in relation to anticipated requisites of
Traditionally, for conventional loading protocols, the
the restorative phase rather than the availability of
implants are left unloaded for 3 to 6 months to allow
bone. Provisional restorations can be used as a
the osseointegration process to take place.1 During this
diagnostic restoration to evaluate the position and
*Private Specialist Prosthodontist, formerly ITI Scholar, Centre for contours of the planned definitive restoration prior to
Implant Dentistry, University of Florida, Gainesville, Florida, USA. surgical implant placement and during the healing
234 Australian Dental Journal 2007;52:3.
Table 1. Provisionalization prior to implant loading
Type of support Prosthesis type
Removable Partial acrylic dentures
Essix appliance
Fixed tooth supported Archwire supported pontic
Resin bonded pontic
Resin bonded, cast metal framework
bridge
Fixed implant supported Transitional implants

phase. A provisional restoration immediately placed

with ovate pontics extending into the extraction
sockets can also be used to preserve the pre-extraction
soft tissue morphology.11 They can guide the healing of
the peri-implant tissue and allow the clinician to Fig 1. Modified removable partial provisional denture. The denture
determine any necessary phonetic or aesthetic adjust- was modified during implant placement to allow proper healing of
the underlying implants. The patient had low smile line.
ments. The clinicians may use information such as
shade, crown and soft tissue contours from the
provisional restoration as a communication tool to the
laboratory. Provisional implant restorations also allow leading to implant exposure, marginal bone loss,
the patient to visualize and evaluate the end restorative and/or failed integration. Often provisional dentures
result, thus assisting in acceptance and/or guiding of are adjusted to minimize contact with the healing
modifications required for the definitive restoration. implants (Fig 1).
There are alternatives to tissue borne provisional
Types of provisional restorations restorations. An Essix appliance12,13 (Fig 2) may be used
Provisional restorations in implant therapy can be in as a removable prosthesis in these cases, as well as in
the form of removable or fixed prostheses. Removable limited interocclusal space or deep anterior overbite.
provisional prostheses are generally tooth and/or soft This prosthesis is made from an acrylic tooth bonded to
tissue borne. Fixed provisional restorations can be a clear vacuform material on a cast of the diagnostic
supported by adjacent teeth or implant retained. They wax up. The prosthesis provides protection to the
can be fabricated chairside, using similar techniques as underlying soft tissue and implant during the healing
in conventional prosthodontics; or in the laboratory on phase. Limitations of this provisional restoration
working casts; or as a combination of indirect-direct include its inability to mould the surrounding soft
technique, where a provisional shell is fabricated before tissue, and lack of patient’s compliance can cause rapid
the patient’s appointment, reducing chairside time. occlusal wear through the vacuform material. However,
Provisional restorations may be constructed prior to some patients may not like to wear, or are unable to
tooth extraction, during socket healing, prior to tolerate, a removable provisional prosthesis, thus fixed
implant placement, or during osseointegration period provisional prosthesis are sometimes necessary.
(Table 1). Provisional restoration could also be
constructed after implant loading, allowing maturation Tooth supported provisional restorations
of peri-implant soft tissue, and during construction of Fixed tooth supported provisional restorations in the
the final prostheses. upper anterior region include the use of orthodontic
brackets and archwire on several teeth adjacent to the
Provisionalization prior to implant loading
Removable prosthesis
Removable partial acrylic dentures have commonly
been used during post-extraction and throughout the
implant therapy. They are simple to construct,
relatively inexpensive, and easy for the surgeon or
restorative clinician to adjust and fit. Patients that
require staged treatment with serial extractions may
have teeth added to their existing removable dentures
with minimal cost. However, they may reduce the
effectiveness of any additional surgical bone and
gingival augmentation procedure used to optimize the
implant site. Care must be taken to prevent the gingival
portion of the provisional partial denture from
contacting the healing soft tissue or an exposed healing
abutment. Soft tissue borne prostheses used during Fig 2. An Essix appliance replacing upper central incisors. The teeth
healing may cause uncontrolled implant loading were spot cured to the clear vacuform template material.
Australian Dental Journal 2007;52:3. 235
 a

Fig 3a. Pre-operative radiograph. The patient had generalized refractory periodontitis, especially in the maxillary arch.
Fig 3b. Pre-operative facial view. One of the patient’s chief complaint was the anterior crowding and the vertical drifting of maxillary
anterior teeth.
Fig 3c. Diagnostic wax up of the planned restoration illustrating anticipated contours of the final restoration. The alignment of anterior
teeth was altered to provide straighter, more aesthetically pleasing teeth. The incisal lengths of maxillary incisors were reduced, decreasing
the horizontal and vertical relationship of the anterior teeth.
Fig 3d. Facial view of prepared teeth immediately after extraction. Strategic teeth were maintained to retain the provisional prosthesis.
The implant sites were previously selected and the non-strategic teeth were removed according to the diagnostic wax up.
Fig 3e. Provisional acrylic restoration prior to insertion. The provisional restoration is relined with compatible self cure resin to fit over
the prepared abutment teeth.
Fig 3f. Fixed provisional restorations cemented on strategic natural abutments. The molars have been retained temporarily to maintain the
vertical dimension of occlusion.

implant site with an attached pontic. An alternative resin and/or ultra high molecular weight polyethylene
method is the use of resin bonded provisional pontic, ribbon (Ribbond Bondable Reinforcement, Ribbon;
which are tooth supported and retained by acid etching Ribbond Inc, Seattle, Wash., USA).8,14 These prostheses
the neighbouring teeth. Sometimes small retentive may continue to be reused as provisionals after an
grooves within enamel on the adjacent teeth can be appropriate implant healing period. The archwire/resin
used to increase retention of the pontic. The pontic can retainer can be removed and reattached between the
be in the form of an acrylic tooth, porcelain, or different surgical and prosthetic stages. They can also
decoronated extracted tooth. The resin bonded acrylic be used to guide the surgeon during grafting procedures
or natural tooth may be reinforced with composite and as a template for the final restoration.
236 Australian Dental Journal 2007;52:3.
 provisional restoration, and the transitional implants
are backed out of position using a ratchet arm and
insertion tool used in the reverse mode (Fig 4).

Post-implant placement
Implant retained provisional restorations
Provisional restorations may be used at the time of
implant placement or after an appropriate healing
period. The term “immediate restoration” is used when
a prosthesis is fixed to the implants within 48 hours
without achieving full occlusal contact with the
opposing dentition, whereas “immediate loading” is
when the prosthesis is fixed to the implants in occlusion
within 48 hours.17
Fig 4. Immediate provisional implants were placed and strategic
teeth were maintained to support long-term telescopic provisional There are several benefits to members of the
restoration. The 14-year-old patient requested a long-term fixed treatment team and patient in using an immediate
provisional restoration until the definitive implants are placed. provisionalization technique. Immediate provisional-
ization offers the patient improved comfort and
A resin bonded, cast metal framework prosthesis function during the implant healing period compared
such as Maryland Bridge is suitable for long-term with a conventional denture.4 There are also fewer
provisionalization in the anterior region, especially in denture adjustments postoperatively with no need for
young patients.8 This type of provisional is difficult to tissue conditioning or relining.
reuse throughout the implant procedure as the bond The decision to immediately restore or load dental
strength between the metal retainer and the enamel can implants is usually made during the treatment planning
be unpredictable during removal and reattachment phase. The treatment can only be confirmed clinically
between procedures. Furthermore, the laboratory costs at the time of implant placement with appropriate
are relatively high. assessment of implant stability, bone quality, and
In some cases, a staged extraction and implant general site health. In a recent consensus review,18 four
placement approach can be adopted.8,15 In this implants in an edentulous mandible, rigidly splinted
technique, the implant sites are selected, and teeth that with a fixed restoration on a framework (acrylic and/or
occupy these sites are extracted while the remaining metal) or hybrid prosthesis, can provide patients with a
teeth are used to support a fixed provisional restoration. reasonable degree of confidence for evidence-based
Usually, natural abutments with poor prognoses are treatment. Primary stability of these implants is crucial
used as interim abutments and can be extracted when in the decision for immediate provisionalization.9,19 The
the implants have integrated. The teeth supported implants need to be well distributed across the
provisional restoration is then converted into an mandibular arch to provide cross-arch stabilization.
implant supported provisional restoration. This The final implant positions are based on the proposed
indirect–direct technique is often used in a full arch restoration through the use of templates/surgical guide.
situation, where the patient’s dentition is failing due to In immediate loading of edentulous mandible, the
periodontal disease (Figs 3a–3f) or when the adjacent patient’s existing denture can be converted into screw
natural teeth require fixed prosthesis at the same time.8 retained provisional fixed hybrid prosthesis. The
technique involves the placement of temporary
Transitional implant provisional restorations cylinders onto the implants and the modification of
In extended partial edentulous areas where there are patient’s existing mandibular denture. These cylinders
no or limited natural abutments to support a are luted to the rest of the denture using self cure resin.
provisional restoration, one or more transitional The denture is then converted into an immediate load,
implants may be used.16 These transitional implants are screw retained provisional hybrid fixed prosthesis with
loaded immediately to support the provisional minimal cantilever and occlusal contacts (Figs 5a–5c).
restoration. They can be used to support fixed A lingual wire may be used within the acrylic
restorations or to retain complete mandibular dentures. framework to provide reinforcement. The provisional
Care should be taken in planning the position of these hybrid restoration will need to remain during the
implants and with their maintenance post-loading. recommended period of implant healing to allow the
They should not interfere with potential implant sites, implants to fully osseointegrate.17
or be placed in poor quality bone. When the depth of This technique may also be used in early or delayed
available bone is less than 14mm or the amount of loading implant protocols. The provisional hybrid
cortical bone is insufficient to provide stabilization, the restoration may have multifunctional uses. It can be
immediate provisional implant may be contraindicated.16 used as a verification jig (Fig 5d) to determine the
Once the implants integrate, the supporting provisional passivity and accuracy of the master impression,
restoration will be converted into implant supported providing all the implants are relatively placed parallel
Australian Dental Journal 2007;52:3. 237
 a
b

Fig 5a. Patient’s existing complete mandibular denture was modified

to accommodate temporary cylinders on the implants. A duplicate
of the denture was used as radiographic and surgical guide for the
planning and surgical phase of the treatment. The three dimensional
positions of the implants were determined from the diagnostic wax
up and clinical and radiographic examination.
Fig 5b. Try in of the mandibular denture over the temporary
cylinders.
Fig 5c. Self cure resin was used to attach the denture and the
temporary cylinders. The denture flange was then trimmed and the
fitting surface was adjusted to allow proper hygiene.
Fig 5d. The provisional hybrid was used as verification jig over the
master cast. The soft tissue moulage was removed to verify the fit of
the provisional on the subgingival implant restorative margins.
Fig 5e. The same provisional hybrid was articulated with a bite
registration material, against the previously articulated study cast.

on the final prosthesis. The decision whether to cement

or screw retain a provisional or final implant
restoration would be dependent on the clinical
situations and clinicians’ preference towards the
method of fixation.
Most implant companies have prefabricated
abutments for cement retained restorations. These
e abutments come in various heights to allow enough
space for the metal and porcelain in crown construction.
They also have a slight taper and an indexing
to each other. It can also be used to articulate the component providing resistance form for the overlying
implant master cast to the opposing study cast (Fig 5e), restorations. The abutments are torqued onto the
and records the laterotrusive functional envelope via implants, left in situ and a complementing pick-up
customized incisal pin guidance. coping component may be used for impression and
transfer of the abutment position to the master cast.
Cement retained provisionals A plastic protection cap, usually cylindrical in shape,
Clinicians have the option to either cement or screw may be cemented on the prefabricated abutment until
retain their final implant restorations.20,21 There are the delivery of the final prosthesis. This technique is
advantages, disadvantages and limitations for each often used by clinicians in non-aesthetic regions of the
option and it is important to understand their influence mouth.
238 Australian Dental Journal 2007;52:3.
 b
a

e f

Fig 6a. A cement on, prefabricated abutment was torqued to the recommended value, six weeks post-placement. The abutment was
chosen to allow adequate space for crown construction within the available interocclusal space.
Fig 6b. A denture tooth with appropriate shade and shape was selected to fit the edentulous space. The acrylic tooth was then hollowed
out to fit over a practice implant analog and abutment extra-orally.
Fig 6c. The denture tooth was relined intra-orally using self cured acrylic resin to capture the indexing component of the abutment.
Fig 6d. The relined denture tooth was fitted over the practice implant extra-orally. Note on the deficiency from the implant margin to the
acrylic tooth due to tissue impingement.
Fig 6e. The deficiency was filled in and the excess material trimmed to the appropriate emergence profile.
Fig 6f. The provisional crown was cemented with provisional cement.

Aesthetic provisional restorations can be constructed subgingivally, especially in the anterior aesthetic region
for such abutments during the period between impres- of the mouth. Access to the deeply placed implant
sion and prosthesis delivery.8 The provisional shoulder can be difficult, and excess residual cements are
restorations are usually made from a prefabricated difficult to clean and may cause peri-implant
custom shell (prefabricated preformed acrylic crowns; inflammation.22 Alternatively, a temporary meso
vacuform template from the diagnostic wax up; abutment would allow a machined connection at
hollowed out denture tooth; or even a hollowed out implant shoulder, and customized cement margin that
decoronated clinical crown) relined using self or light can be modified to allow a slightly subgingival
cured resins intra-orally to capture the indexing restorative margin for ease of cement removal. This
component of the abutment, and then completed extra- abutment can be modified intra- or extra-orally,
orally to fit the implant restorative margins (Figs 6a–6f). prepared using diamond bur with accessible cement level
To facilitate treatment, the crown form can be waxed placed just below the gingival margin, and correction of
up, or selected, sized, and trimmed ahead of time to fit any angulation problems to retain the provisional crown
the edentulous site on the study cast. can be made. A cementable provisional crown is then
Care should be taken during the cementation constructed using conventional crown and bridge
procedure where the crown margin is placed deep technique (Figs 7a and 7b).
Australian Dental Journal 2007;52:3. 239
 a a

b b

Fig 7a. A temporary meso abutment, one piece temporary abutment Fig 8a. A screw retained provisional crown was made at chairside
fits directly into the implant body. The abutment is made of PEEK from the patient’s existing partial denture, attached to the
(Polyetheretherketone) plastic and titanium inlay. temporary cylinder using additional self cure resin. The excess
Fig 7b. Unaltered temporary meso abutment on the soft tissue temporary cylinder is reduced to follow the palatal contour of the
working cast. The abutment can be prepared in the laboratory or existing partial denture and patient’s occlusion.
chairside with altered cement margin and corrections of any Fig 8b. Facial view of screw retained provisional restoration on
angulation problems. tooth 11 site. The provisional restoration was hand tightened.

Screw retained provisional prostheses final prosthesis must be able to imitate the natural
Screw retained provisional restorations would tooth crown form when emerging from the gingival
eliminate the possibility of having any temporary tissues with narrow margins to fit the implant head.
cement present in the peri-implant tissue. This can be This transition zone between the implant shoulder to
achieved using temporary cylinders directly placed on the gingival crest, often up to the contact points is
the implant level. The provisional crown can then be shaped by the subgingival part of the provisional
built up in the laboratory on the master cast or restorations. The transition zone can be up to 5mm
chairside by using self or light cure resin or composite deep, especially in the palatal and interproximal tissues
resin according to the diagnostic wax up. The of teeth in the aesthetic zone. The peri-implant tissues
temporary cylinder often has to be adjusted to fit into
the occlusion (Figs 8a and 8b).
The most important advantage of provisional
restorations at the start of the restorative procedure is
in shaping of the peri-implant tissues.8,23 This process
will establish a natural and aesthetic soft tissue form
that will help the laboratory fabrication with an
anatomically appropriate soft tissue model.24-26 A well-
shaped peri-implant tissue including interdental
papillae will facilitate seating of the final prosthesis.
The provisional restoration can be modified over
several appointments to achieve the desired emergence
profile (Fig 9).

Communication with laboratory using provisionals

One of the challenges faced by the restorative Fig 9. Moulded soft tissue from screw retained, 3 unit fixed acrylic
provisional bridge. Peri-implant tissue was shaped with screw
clinician is the circular shape and small diameter of the retained provisional restoration for 4 weeks prior. The pontic shape
implant compared to the root of a natural tooth. The was moulded using additional resin during the healing period.
240 Australian Dental Journal 2007;52:3.
 a
a

Fig 10a. Resultant emergence profile shaped by the provisional

restoration in Fig 8, after approximately 4 weeks of
provisionalization. The mature peri-implant tissue has an oblong
shape compared to the circular implant restorative collar.
Fig 10b. A custom impression coping with screw on impression
coping replicated from the provisional restoration was placed over
the implant prior to final impression.
c

must be permitted to adapt to the dimensions of the

provisional restoration.
Following the shaping and maturation of the peri-
implant tissue, the clinician needs to transfer this
information to the working cast.27,28 This may be
accomplished with a custom impression coping or by
retrofitting the provisional restoration to the working
cast (Figs 10a and 10b). The customized impression
coping allows the clinician to capture the moulded soft
tissue with the appropriate emergence profile onto the
master cast.
In aesthetic cases, the shade and surface
characterization of the provisional restorations can be d
altered using composite modifiers (Figs 11a–11d).
Fig 11a. Screw retained, 3 unit fixed acrylic provisional bridge
Shades and surface characterization on the provisional constructed to replace the modified removable partial denture from
restoration can be used by the treatment team, Fig 1. The provisional restoration had a monochromatic shade
including the patient to evaluate the desired shade of similar to the pre-existing denture teeth.
the final restoration. Fig 11b. Colour modifiers for tooth shading characterizations. The
modifiers can be mixed together and incorporated into the
provisional acrylic/composite resin crown to mask discolouration
CONCLUSION and/or create surface characterizations.
This article discussed the role of provisionalization in Fig 11c. Aesthetic provisional restoration with customized shade
characterization.
implant therapy from the removal of teeth, through Fig 11d. Laboratory shade prescription for the final ceramic
implant placement to the final implant restoration. restoration, incorporating the custom shade characterization.
Australian Dental Journal 2007;52:3. 241
Various provisionalization options were discussed with 11. Margeas RC. Predictable peri implant gingival esthetics: use of
the natural tooth as a provisional following implant placement. J
some examples presented. Provisionalization of Esthet Restor Dent 2006;18:5-12.
implants is often overlooked, as the time between
12. Sheridan JJ, Ledoux W, McMinn R. Essix retainers: fabrication
impression and delivery of the final prosthesis can be and supervision for permanent retention. J Clin Orthod
short. Fixed provisionals would also help those patients 1993;27:37-45.
that have not had removable prostheses before, 13. Moskowitz EM, Sheridan JJ, Celenza F, Tovilo K, Munoz AM.
providing a restoration which has superior comfort and Essix appliances. Provisional anterior prosthesis for pre and post
implant patients. N Y State Dent J 1997;63:32-35.
aesthetics. Clinicians need to be aware of the range of
14. Smidt A. Esthetic provisional replacement of a single anterior
techniques, materials and temporary implant tooth during the implant healing phase: a clinical report. J
components for short, medium and long-term Prosthet Dent 2002;87:598-602.
provisionalization. 15. Perel ML. Sequencing and integration of periodontal,
The need for provisionalization should be considered prosthodontic and implant therapies. Int J Oral Implantol
1990;7:19-22.
during the treatment planning stage, and reassessed
16. Babbush CA. Provisional implants: surgical and prosthetic
continually throughout the implant therapy. Clinicians aspects. Implant Dent 2001;10:113-120.
also need to be able to transfer the information
17. Morton D, Jaffin R, Weber HP. Immediate restoration and
gathered from the provisional restoration to the loading of dental implants: clinical considerations and protocols.
laboratory. Construction of provisional restoration Int J Oral Maxillofac Implants 2004;19 Suppl:103-108.
may take up more chairside time but they may save 18. Cochran DL, Morton D, Weber HP. Consensus statements and
time and expense at subsequent appointments, hence recommended clinical procedures regarding loading protocols for
endosseous dental implants. Int J Oral Maxillofac Implants
producing better restorations. There may be added 2004;19 Suppl:109-113.
costs associated with increased chairside time and 19. Balshi TJ, Wolfinger GJ. Immediate loading of Brånemark
additional components, however these will be offset by implants in edentulous mandibles: a preliminary report. Implant
the improvement in overall patients’ treatment and Dent 1997;6:83-88.
their acceptance towards the treatment. 20. Michalakis KX, Hirayama H, Garefis PD. Cement-retained
versus screw-retained implant restorations: A critical review. Int
J Oral Maxillofac Implants 2003;18:719-728.
ACKNOWLEDGEMENT
21. Hebel KS, Gajjar RC. Cement-retained versus screw-retained
The authors would like to acknowledge the implant restorations: achieving optimal occlusion and esthetics in
assistance of Dr James Mumme and Dr Debra implant dentistry. J Prosthet Dent 1997;77:28-35.
McAuslan in the preparation of this document. 22. Pauletto N, Lahiffe BJ, Walton JN. Complications associated
with excess cement around crowns on osseointegrated implants:
a clinical report. Int J Oral Maxillofac Implants 1999;14:865-
REFERENCES 868.
1. Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study 23. Chee WW, Donovan T. Use of provisional restorations to
of osseointegrated implants in the treatment of the edentulous enhance soft-tissue contours for implant restorations. Compend
jaw. Int J Oral Surg 1981;10:387-416. Contin Educ Dent 1998;19:481-489.
2. Buser D, Mericske-Stern R, Bernard JP, et al. Long-term 24. Higginbottom F, Belser U, Jones JD, Keith SE. Prosthetic manage-
evaluation of non-submerged ITI implants. Part 1: 8-year life ment of implants in the esthetic zone. Int J Oral Maxillofac
table analysis of a prospective multi-center study with 2359 Implants 2004;19 Suppl:62-72.
implants. Clin Oral Implants Res 1997;8:161-172.
25. Sadan A, Blatz MB, Salinas TJ, Block MS. Single-implant restora-
3. Weber C, Crohin CC, Fiorellini JP. A 5-year prospective clinical tions: a contemporary approach for achieving a predictable
and radiographic study of non-submerged dental implants. Clin outcome. J Oral Maxillofac Surg 2004;62 Suppl:73-81.
Oral Implants Res 2000;11:144-153.
26. Biggs WF. Placement of a custom implant provisional restoration
4. Wohrle PS. Single-tooth replacement in the aesthetic zone with at the second-stage surgery for improved gingival management: a
immediate provisionalization: fourteen consecutive case reports. clinical report. J Prosthet Dent 1996;75:231-233.
Pract Periodontics Aesthet Dent 1998;10:1107-1114.
27. Chee WW, Cho GC, Ha S. Replicating soft tissue contours on
5. Garber DA. The esthetic dental implant: letting the restoration be working casts for implant restorations. J Prosthodont
the guide. J Am Dent Assoc 1995;126:319-325. 1997;6:218-220.
6. Garber DA, Belser U. Restoration-driven implant placement with 28. Buskin R, Salinas TJ. Transferring emergence profile created
restoration-generated site development. Compend Contin Educ from the provisional to the definitive restoration. Pract
Dent 1995;16:796-804. Periodontics Aesthet Dent 1998;10:1171-1179.
7. Kan JYK, Rungcharassaeng K, Kois JC. Removable ovate pontic
for peri-implant architecture preservation during immediate
implant placement. Pract Proced Aesthet Dent 2001;13:711-715.
8. Priest G. Esthetic potential of single-implant provisional Address for correspondence/reprints:
restorations: selection criteria of available alternatives. J Esthet
Restor Dent 2006;18:326-338.
Dr Robert Santosa
Suite 44, Level 4
9. Cibirka RM, Linebaugh ML. The fixed/detachable implant
provisional prosthesis. J Prosthodont 1997;6:149-152. 183 Macquarie Street
10. The glossary of prosthodontic terms. 8th edn. J Prosthet Dent Sydney, New South Wales 2000
2005;94:46. Email: [email protected]

242 Australian Dental Journal 2007;52:3.

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