Temporising dental implant cases
Although you will already be making temporary prostheses every day for your non-implant patients, there are some design requirements that are critical when being made for use during implant treatment.
When temporaries are needed, we will always send patients back to you to have any necessary temporary prostheses made, (please let us know on the referral form if you would prefer us to make these ourselves). In almost every case this temporary prosthesis will be either a resin-bonded bridge or a removable partial denture, to immediately replace an upper tooth in the aesthetic zone.
Resin Bonded Bridges
These should have a single, non-perforated, sand-blasted metal wing, (Maryland style).
During implant treatment, it will be necessary for us to significantly adjust the pontic following any bone grafting and so the pontic should NOT be made out
of porcelain.
Instead the pontic should be made out of either acrylic or, preferably, composite material which can be easily adjusted and, if necessary, added to.
The metal reinforcing arm that extends into the pontic from the wing should also be kept narrow to avoid it becoming exposed when we grind the pontic down to size, (we all know how hard it is to grind Co/Cr!)
Immediate Partial Dentures
In the aesthetic zone, almost every patient will receive a particulate bone graft to augment the site when an implant is placed. It is therefore essential that when a partial denture is worn, it does not press down into the grafted site, even during eating. If it does, the result is exactly like someone stepping onto a sandcastle, with the graft being squashed beneath the denture-tooth.
Maxillary partial dentures should be well-extended into the palate, (and yes, we do know how much the patients hate this!), to prevent excessive forces being transmitted to the graft.
The denture should also have Adam’s cribs attached, if possible, to the molars. These will not only significantly aid retention and stability of the denture (which the patients will love), but will also help to prevent tipping of the denture during eating.
Please be aware that not every dental laboratory is familiar with how important these specialist features are when making immediate prostheses for implant treatment, so please send these temporary restorations to be made by Implant Restorations Limited, as we have spent a great deal of time explaining exactly what we require and ensuring that they provide what we need for your patients.
