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Biomedical subjects

George Priest

Publications and source records attributed to George Priest.

7 recordsLinked to original sources

Esthetic potential of single-implant provisional restorations: selection criteria of available alternatives.

UNLABELLED: Provisional implant restorations are essential tools used to optimize the esthetic outcomes for single-tooth implant restorations. This article describes three groups of available alternatives and the specific options within each group including removable prostheses (interim removable partial denture, vacuum-formed appliance), tooth-supported prostheses (bonded extracted or denture teeth, cast metal or fiber-reinforced resin-bonded fixed partial denture [FPD], wire-retained resin-bonded FPD, acrylic resin provisional FPD), and implant-supported fixed prostheses (implant-retained provisional restoration). Advantages and disadvantages as well as fabrication guidelines for each option are provided. The author proposes that the restorative dentist consider eight criteria in selecting the most appropriate type of provisional prosthesis for a specific patient situation including the esthetic potential, patient comfort, treatment time, laboratory cost, occlusal clearance, ease of removal, durability, and ease of modification. The patient's esthetic expectations are critical in determining the most suitable type of provisional restoration. Esthetically pleasing provisional restorations are part of the evolving implant continuum, making implant dentistry more appealing to practicing dentists and potential patients. CLINICAL SIGNIFICANCE: Provisional restorations for single implants have evolved from temporary expedients during osseous and soft tissue integration to critical therapeutic tools used to assess patient expectations, communicate with the laboratory, and optimize definitive implant treatment. The selection of the type of provisional restoration may significantly influence esthetics during the period of implant integration and soft tissue healing. However, it is unlikely that there is a direct correlation between the type of provisional restoration used and the esthetic outcome of the definitive prosthesis.

Acrylic Resins↗

Virtual-designed and computer-milled implant abutments.

Computer-designed and -generated implant abutments will fundamentally change the present restorative protocols for implant dentistry. Standard implant prosthetic techniques rely on implant level impressions and costly casting technology for component fabrication. Many dentists are uncomfortable making implant level impressions and resort to time-consuming conventional techniques of intraoral abutment preparation or do not offer implants as a treatment alternative. Implant abutments generated by computer-aided design and computer-aided manufacturing (CAD/CAM) are more precise than those created using traditional casting technology. This increased accuracy has specific application to implant dentistry, where precision of components may affect implant longevity, prosthetic success, and ease of restoration. Three current CAD/CAM implant abutment systems are reviewed, including an innovative digital system which eliminates the need to make implant level impressions. After placing an encoded healing abutment, an impression is made at the healing abutment level. The resulting cast is optically scanned and, using a CAD/CAM system, a patient specific definitive abutment is created. The encoded healing abutment is not removed until delivery of the abutment and final prosthesis. The ease and precision of making implant impressions at the healing abutment level, followed by patient-specific computer-generated abutments presents several benefits: restorative dentists rely less on conventional dental techniques to restore implants, inaccuracies of casting technology are virtually eliminated, laboratory technicians are freed to concentrate on higher level activities, and ultimately dentists are more likely to embrace implants as a preferred treatment option for their patients. This cutting edge technology of computer-assisted implant impressions and computer-generated abutments will likely replace traditional implant restorative protocols and become the standard for implant dentistry in the foreseeable future.

Computer-Aided Design↗

Promoting esthetic procedures in the prosthodontic practice.

The demand for esthetic services is large and growing. Emphasis on enhancing personal appearance is demonstrated in patients' increased demands for elective esthetic procedures. The techniques that have fueled this Esthetic Cultural Revolution fall under the expertise of prosthodontists. Prosthodontists, therefore, are in a position to establish themselves as the most qualified providers of these services. Prosthodontists must leverage their technical and treatment planning strengths with effective marketing strategies to address the esthetic expectations of today's patients. Marketing techniques with specific relevance to prosthodontists and esthetic dentistry are detailed.

Advertising↗

Proximal margin modifications for all-ceramic veneers.

Conventional ceramic veneers circumvent contact areas and extend palatally in the gingival third of the tooth only. Veneers are no longer considered reversible therapy. With the objective of longevity in mind, proximal extensions beyond contact areas maximize the functional and aesthetic potential of veneers and maintain conservative tooth preparations. The clinical and laboratory advantages of proximal veneer extensions for anterior teeth significantly outweigh the disadvantage of increased tooth structure removal. This article presents a modified preparation technique for the proximal extension of ceramic veneer preparations in the anterior region.

Dental Porcelain↗

Predictability of soft tissue form around single-tooth implant restorations.

The objective of this study was to answer important questions about gingival responses to single-tooth implants: (1) Are papilla regeneration and sulcular recession expected results? (2) Do soft tissue profiles retain their sulcular form over an extended period? and (3) Do single-implant replacements require special restorative handling to achieve predictable soft tissue form? A retrospective, photographic examination was used to follow 55 single-implant restorations in 51 patients for a period from 1 to 9 years (mean 3.5 years). Papillae regenerated in 83.9% of implants for a mean growth of 0.65 mm mesially and 0.62 mm distally. The sulcular apex receded in 59% of patients for a mean of 0.06 mm. Complete papilla fill was noted in 75% of patients examined. Short- to long-term measurements revealed that papilla regrowth continued slightly and that sulcular recession abated. Papilla regeneration around single implants was a predictable outcome in this population; sulcular recession was not a predictable finding. Papilla levels demonstrated a tendency toward increasing height, and sulcular levels remained fairly constant over the long term. Predictable soft tissue profiles were achieved with a simplified implant prosthetic protocol, progressing directly from healing abutments to definitive crowns in most cases.

Adolescent↗