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ePaper created 2017-03-17, 10:24:23 | version 1.38.0
Fig. 1 Fig. 2 Fig. 1 A screw-retained provisional restoration. Fig. 2 The soft-tissue aspect after conditioning with provisional crowns. Figs. 3a–d The provisional restoration is unscrewed from the oral cavity, screwed to a laboratory implant analogue and embedded in casting material (a). Polyether material poured at the level of the prosthetic emergence profile and surrounding provisional crown (b). Removal of the Provisional (c). A conventional impression coping screwed on (g). (d). Note the gap between the standard coping and impression material. Figs. 3a–d Clinical procedures This prosthetic procedure is to be used after the healing of the periimplant soft-tissue by means of standard healing abutments so that a round shape of the periimplant mucosa can be achieved. An impression can then be obtained by screwing the standard pickup coping to the fixture. A polyether (Impregum, 3M ESPE) material can be used for the im- pression in order to provide a provisional screw-retained prosthesis (Fig. 1). This provisional restoration is provided to create and condition the periimplant soft-tissue contours, thus reproducing the physiological scalloped, parabolic ap- pearance and the tropism of the adjacent gingiva. The resin provisional prosthesis is kept in the oral cavity for a period of three to six months to ensure a stable outcome of the periimplant soft-tissue condition- ing process. During this period, the pa- tient should be followed monthly and the clinician should adapt the provisional prosthesis by adding or removing small amounts of resin as necessary in order to obtain the required shape for the gingival contours and the appropriate emergence profile. This conditioning process has to be carried out gradually to avoid excessive compression, which would cause unac- ceptable discomfort for the patient. Once the required gingival morphology has been achieved (Fig. 2), the procedures for providing the definitive restoration can be carried out. The implant analogue is embedded into laboratory stone (or plas- ter) in a mixing cup and allowed to set. This Article Digital Workflow and Esthetics issue 2017 — 23