Provisional restoration for an osseointegrated single maxillary anterior implant.

“Clinical Showcase” is a series of pictorial essays that focus on the technical art of clinical dentistry. The section features stepby-step case demonstrations of clinical problems encountered in dental practice. If you would like to contribute to this section, contact editor-in-chief Dr. John O’Keefe at [email protected]. The preparation of esthetically appealing and anatomically correct implant-supported provisional restorations facilitates fabrication of the final implant-supported crown. The provisional restoration is used to mould and manipulate the soft tissue and acts as a blueprint or template for the final crown (Fig. 1).1,2,3 This type of restoration should be placed several weeks before the final impression is taken, to allow for maturation of the peri-implant tissue. My preferred method involves chairside fabrication of a fixed provisional restoration using an acrylic denture tooth affixed to a screw-retained temporary cylinder. The acrylic denture tooth is attached to the temporary cylinder with autopolymerizing acrylic, which is then retained to the implant fixture with a screw. The following technique provides an esthetic, functional and stable provisional restoration. Details of the Procedure 1) Remove the healing abutment and immediately replace it with a screwretained temporary cylinder (Fig. 2). Any delay may result in collapse of the gingival tissue over the fixture platform, which will make it difficult to seat the temporary cylinder. 2) Adjust the cylinder by reducing its length enough to allow the teeth to meet in centric occlusion. 3) Roughen the cylinder surface to enhance adhesion of the acrylic (Fig. 3), and then seal the lingual screw hole with boxing wax to protect the screw from the autopolymerizing acrylic that will be used (Fig. 4). 4) Select an appropriate acrylic denture tooth with matching shade, colour and form. Reduce the lingual surface of the acrylic denture tooth, keeping the labial veneer intact (Fig. 5). The lingual surface should be concave and should fit around the temporary cylinder with the labial