Provisional restorations in soft tissue management around dental implants.
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Dental Implantation, Endosseous↗
Biomedical subjects
W W Chee
Publications and source records attributed to W W Chee.
An in vitro comparison of 5 techniques for impressing dowel space preparations.
PURPOSE: This in vitro study compared 5 different dowel space impression techniques using polyvinyl siloxane impression material to determine which method produced fewer voids in the dowel space impression. MATERIALS AND METHODS: Five techniques were used to make impressions of a prepared dowel space in a simulated endodontically treated tooth. Technique I used a 25-gauge anesthetic needle to act as a vent at the apex of the preparation to reduce voids produced during the expression of light body impression material. The anesthetic needle was removed after the impression material was injected, and an impression post was then inserted to the depth of the preparation. Twenty impressions made using this technique were compared with other techniques that used the vent without a post, no vent with a post, no vent without a post, and a lentulo spiral with a post (Techniques II through V, respectively). The percentage of impressions with voids from each group was compared to determine which technique consistently produced a void-free impression of the complete preparation length. If voids were observed in the impression, the specimen was considered inadequate. RESULTS: The percents of void-free impressions using Techniques I through V were 100%, 70%, 40%, 60%, and 20%, respectively. CONCLUSIONS: Using a 25-gauge needle as a vent while expressing impression material into the dowel space followed by placing the impression post consistently produced void-free dowel space impressions.
Dental Impression Materials↗
A technique to replicate soft tissues around fixed restoration pontics on working casts.
When missing maxillary incisors are replaced, the patient's primary concern is usually esthetics. Depending on the patient's smile line and the display of the incisors, the esthetic zone may extend to the entire clinical crown and include the surrounding soft tissue. For these patients, the appearance and form of the soft tissue at the base of the pontics is as critical as the esthetics of the incisal edges of the restoration. A technique is presented to precisely transfer the soft tissue morphology of the pontic area to the working cast. This modified master cast allows the laboratory technician to fabricate restorations that will harmonize precisely with the soft tissues of the patient.
Dental Impression Technique↗
Impression technique for arches requiring both implant and natural tooth restorations.
Implant impression copings reduce access to prepared teeth during the impression-making process. If the impression copings and teeth are in close proximity, it may be difficult to extrude impression material circumferentially around the margins of the tooth preparations. A technique is described that allows the impressions of the prepared teeth to be made without the implant impression copings interfering. The advantages and disadvantages of the technique are discussed.
Dental Abutments↗
Retrievable cemented implant restorations.
Prostheses can be attached to implants or implant abutments by screw retention, cementation, or with the use of set-screws. The indications for non-screw-retained restorations are discussed with respect to implant body position and surgical limitations for implant placement. The advantages and disadvantages of each method are outlined. A technique that uses a screw threaded into the implant restoration to displace the cemented restoration is presented. Use of this technique will allow predictable removal of the cemented restorations without damage to the prosthesis or abutment.
Cementation↗
Use of provisional restorations to enhance soft-tissue contours for implant restorations.
The objective of restoring missing teeth with implant-supported restorations should not merely be achieving osseointegration with an implant and a biomechanically sound restoration. The objective must be the esthetic and functional restoration of the missing teeth. To achieve this, proper treatment planning is critical. Precise implant placement and delicate soft-tissue manipulation during surgery will allow the restorative dentist to enhance the peri-implant soft-tissue contours with the use of provisional restorations. Empirically, it seems that the earlier the provisional restoration is delivered in the treatment process the more ideal the esthetics. Several methods of using provisional restorations to enhance soft-tissue contours are presented. The concept of immediately delivering provisional restorations on placement of an implant is discussed.
Dental Implantation, Endosseous↗
Rational use of contemporary all-ceramic crown systems.
There are a host of contemporary all-ceramic systems available today, as well as improved techniques for metal-ceramic restorations. Perhaps the most important factor in achieving predictable success with these restorations is excellent soft tissue management. Metal-ceramic restorations provide the most predictable service in terms of clinical longevity, versatility and prevention of wear to the opposing dentition.
Biocompatible Materials↗
Clinical experiences with bonded porcelain laminate veneers.
Bonded porcelain veneers can provide successful esthetic and functional long-term service for patients. The purpose of this article is to describe the authors' clinical experiences with veneers over the past decade and to outline the procedures required to achieve predictable success with this conservative esthetic restorative modality. It is hoped that the authors' experiences and those of others will encourage practitioners to consider more routine use of this type of restoration in many of their more complex reconstructive cases.
Dental Bonding↗
A rationale for not connecting implants to natural teeth.
When restoring partially edentulous arches with implants, there are some practitioners who believe it is occasionally beneficial to connect implants to natural teeth. This connection is performed to gain shared support from the natural tooth and implant, prevent rotation of the restoration, or sometimes merely to retain the natural tooth. A discussion and review of the literature concerning this connection is presented, and a patient treatment is shown to illustrate potential complications.
Dental Abutments↗
Replicating soft tissue contours on working casts for implant restorations.
Restoration of partially edentulous arches is often aided by the use of dental implants. When anterior edentulous spaces are restored, the clinician is challenged to provide an esthetic and functional restoration. The soft tissue that surrounds the implant restoration and the soft tissue at the base of the pontics are important factors in achieving an esthetic result. A technique is presented that will allow soft tissue morphology of both peri-implant and pontic bearing soft tissue to be incorporated into the working cast utilizing a provisional restoration. This allows the fabrication of a restoration that will harmonize with the soft tissue form of the patient.
Dental Abutments↗
Restoration of an anterior edentulous space.
Removable partial dentures are often overlooked as a restorative option for an anterior edentulous space. This article will focus on the advantages and disadvantages of removable prostheses for the restoration of the anterior edentulous space in specific clinical situations.
Dental Abutments↗
Esthetic replacement of the anterior tooth with an implant-supported restoration.
The use of implants in esthetic areas is complex because the implant must be placed in a precise location to support an esthetic restoration. This paper will focus on the treatment planning and sequencing for the restoration of single anterior teeth with implant-supported restorations. The factors necessary for a predictable esthetic outcome will be discussed.
Alveolar Process↗
Compatibility of elastomeric impression materials for use as soft tissue casts.
The communication of soft tissue contours from the clinical situation to the laboratory technician through the laboratory phases of the dental implant restoration is enhanced with the use of soft tissue casts. Modern elastomeric impression materials can function well as both the master impression and soft tissue cast materials. The purpose of this study was to test the compatibility of a variety of elastomeric impression materials and commercially available soft tissue cast materials with various matrix impression materials. Chemical interaction between the materials may result in adhesion or inhibition of the set of the soft tissue cast material. The results of this study indicated that consideration must be given to material compatibility if predictably successful results are to be achieved in soft tissue cast fabrication.
Dental Impression Materials↗
Tensile bond strength of polyvinyl siloxane impressions bonded to a custom tray as a function of drying time: Part I.
Time-dependent bond strength studies of two polyvinyl siloxane impression materials to acrylic resin disks with their respective adhesives were studied to determine the optimal time for maximum bond strength. Six groups were tested with varying adhesive dry times of 0, 7, 15, and 60 minutes and 8 and 24 hours before testing. The results indicated that the bond strength of the adhesive increased at least twofold from time zero to 7 minutes adhesive dry time and peaked at 60 minutes for one of the materials and at 8 hours for the other. Bond strengths increased rapidly to the 15-minute test interval and then seemed to plateau. Both materials exhibited decreased adhesive bond strengths at 24 hours.
Acrylic Resins↗
Efficient soldering index materials for fixed partial dentures and implant substructures.
Multiple-unit fixed partial dentures routinely require an intraoral index to ensure accurate fit. One of the most commonly used materials is Duralay acrylic resin, which has yielded satisfactory clinical results, but one disadvantage has been a prolonged setting time. This study compared the setting times of two autopolymerizing resins, Duralay and G. C. Pattern resin. The dimensional accuracy of these materials was also compared with one light-cured resin, G.C. Unifast light-cure resin. All three materials were suitable to relate castings with clinically acceptable outcomes, and chairside time could be saved with the use of recently introduced indexing materials.
Dental Abutments↗
Treatment planning and soft tissue management for optimal implant aesthetics.
Aesthetic restoration of single anterior teeth is one of the most difficult procedures to execute. This article discusses patient selection criteria, implant position and its relationship to the aesthetic outcome. The importance of soft tissue management in all phases of surgical and restorative phases is emphasized. Guidelines are given for the successful delivery of this service for the patient that will preserve adjacent teeth and fulfill functional and aesthetic needs.
Dental Implantation, Endosseous↗
Development of implant soft tissue emergence profile: a technique.
Despite successful osseointegration of dental implants, patients can be dissatisfied with the definitive restoration because of a poor esthetic result. An esthetic implant restoration depends on correct implant placement and a well-designed and fabricated prosthesis that includes the prosthetic teeth and the surrounding whether it is acrylic resin or soft tissue. This article describes a technique to help predict, develop, and evaluate implant prostheses and their soft tissue contours at the provisional restoration stage. This technique records the planned and subsequently proven contours, which are then used to guide fabrication of the final prosthesis and produce a predictable esthetic result.
Dental Abutments↗
Inhibition of polymerization of polyvinyl siloxanes by medicaments used on gingival retraction cords.
Inhibition of polymerization of polyvinyl siloxane materials by latex products is well documented. It is thought to be caused by contamination of the chloroplatinic acid catalyst by sulfur compounds. Many medicaments, such as aluminum sulfate and ferric sulfate, used on gingival retraction cords have been accused of causing inhibition of set of polyvinyl siloxane materials. Several of these medicaments were tested with two polyvinyl siloxanes and found not to cause any inhibition of set.
Alum Compounds↗