Why are provisional prostheses provided?
There are many reasons why clinicians would consider provisional prostheses during the implant healing period.
These would include:
- Restoring function of missing teeth
- Restoring aesthetics
- Space maintenance when adjacent or opposing teeth are present
- As a provisional to aid the design/appearance of the final restoration
- Aids in patient management
- Helps healing of the soft tissues in the implant site
- Improving tissue contours
- Aids in the development of inter-implant papillae
What are the different factors to consider?
- Inter-occlusal space
- Ease of construction and modification
- Ease of removal
Interim prostheses can be used in 3 phases: before placing the implant, after placing the implant in the unloading time and after placing the implant in loading time.
The healing time following tooth extraction is usually a period of 2-4 months (no grafting) or 4-8 months. Ideally a prosthesis that doesn’t exert too much pressure on the grafting site is desirable.
The 4 main options
Acrylic removable partial denture:
|+ Helps bone remodeling||– Poor retention and stability|
|+ Cheaper||– Undesirable pressure on implant sites|
|+ Replaces multiple teeth||– Uncontrolled implant loading|
|+ Easy to fabricate and adjust|
|+ Allows easy multiple access to implant site|
Adhesive bridges or fibre-reinforced composite bridges
|+ Better tolerated by patients as better retention/stability/aesthetics||– Reduced access to implant site|
|+ Reduced pressure on implant site||– Can be difficult to remove|
|+ Good for single tooth sites||– Costly for multiple teeth|
|+ Good for limited occlusal space and deep anterior overbite||– Poor Aesthetics|
|+ Reduced pressure on implant site||– Does not mold surrounding tissues|
|– Poor compliance with patients|
Fixed implant support prostheses with provisional narrower diameter implants
|+ Greater patient compliance as not removable||– Improper placement can cause damage to alveolar ridge/permanent implants|
|+ Good for full arch missing teeth or multiple missing teeth||– In single tooth cases, lack of space so difficult to use|
|+ Minimal surgical intervention||– Implants can fracture|
See the references section below for the main article that was used to inform the piece above. Whilst other options/derivatives do exist, this article aimed to provide the main options to clinicans. There is further scope to discuss the dental materials of these provisional prostheses that may be addressed later.
Feature image: https://doi.org/10.5051/jpis.2011.41.6.302
Other images: Fibre-reinforced direct composite bridges – http://www.fibrebond.co.uk
Siadat, H., Alikhasi, M., & Beyabanaki, E. (2017). Interim Prosthesis Options for Dental Implants, 26, 331–338. https://doi.org/10.1111/jopr.12421