Immediate provisionalization with a CAD/CAM interim abutment and crown: A guided soft tissue healing technique Periklis Proussaefs, DDS, MS Loma Linda University, School of Dentistry, Loma Linda, Calif A technique is described in which a single interim abutment and crown were fabricated in advance and placed the day of dental implant surgery. The contours of the interim crown were identical to the contours of a tentatively designed definitive prosthesis and allowed the tissue to heal and obtain contours that accommodated the contours of the definitive prosthesis. After osseointegration was established, a definitive impression was made with a custom computer-assisted design and computer-assisted manufacturing impression coping. The definitive prosthesis then was fabricated. (J Prosthet Dent 2014;-: ---) Dental implants were introduced for the treatment of patients with complete edentulism.1 However, soon after their introduction, dental implants became a valid treatment for patients with partial edentulism.2,3 For these individuals, providing interim restorations is important because these restorations help confirm the diagnostic design,4,5 esthetics,4-6 and contours,4-8 which can be replicated in the definitive prosthesis.9-11 The healing response around the abutments can be evaluated,8,10-12 and the soft tissue around the fixtures can heal according to the contours of the definitive prosthesis.6,10,11,13,14 Interim restorations also allow the osseointegration of the fixture to be observed.14 The conventional protocol indicated that a healing period of 3 to 6 months is recommended to achieve osseointegration before loading the implants with a prosthesis.15 Immediate loading is a technique for eliminating the 3- to 6month healing period. The technique has been described in combination with mandibular bar-retained overdentures,16-18 complete arch implantsupported screw-retained prostheses,19-23 and with partial edentulism.24-32 Regardless of the technique, various methods have been proposed and used33-36 to transfer soft tissue architecture to the laboratory so the definitive prosthesis can be fabricated
in accordance with the acquired soft tissue morphology. The purpose of the current technique report was to describe a method for the immediate loading of single root form implants with a computer-assisted design and computer-assisted manufacturing (CAD/ CAM) interim restoration.
TECHNIQUE 1. Evaluate the tissue around the edentulous area for signs or symptoms of pathosis (Fig. 1). Make complete arch preliminary impressions preoperatively from the patient’s maxillary and mandibular arches by using polyvinyl siloxane impression material (Silgimix; Sultan Healthcare). Make an interocclusal record with polyvinyl siloxane occlusal registration material (Exabite II NSD; GC America Inc) at the maximum intercuspation position. In addition, after providing local anesthesia, map the alveolar ridge by using an endodontic file with a rubber stop.37 With this technique, the thickness of the soft tissue is measured around the area of the prospective implant surgery. 2. Scan the impressions (D700 scanner; 3Shape) and simulate the definitive prosthesis with the provided software. The computer software, which is incorporated into the scanner, allows the size and shape of each component to be designed digitally by
Assistant Professor, Advance Education Program in Implant Dentistry.
Proussaefs
using precise measurements. With the contours of the definitive prosthesis as reference, fabricate a custom interim abutment from a polymethyl methacrylate (PMMA) block with a milling machine (TS150 Milling Solution; IOS Technologies). An interim crown also can be milled from a PMMA block according to the computer-designed contours of the definitive prosthesis (Fig. 2). Design the interim crown to be slightly in infraocclusion and to provide a relief space between the interim abutment and the crown. Position the margins of the interim abutment according to the thickness of the soft tissue measured during ridge mapping. The goal is to position the margins 0.5 mm subgingivally on the facial aspect of the restoration for good esthetics so that the interim abutmente crown transition line is not visible. Fabricate the interim abutment and crown in the laboratory before implant surgery is scheduled. 3. Fabricate a CAD/CAM custom impression coping from a PMMA block (Fig. 3). The CAD/CAM interim crown can be evaluated on the diagnostic stone cast to confirm ideal contours, contact areas, and esthetics (Fig. 4). 4. Place the dental implant with the patient under local anesthesia and with the aid of a surgical stent and copious saline solution irrigation. For this patient, a threaded, root form,
2
Volume
1 Preoperative evaluation, occlusal view.
3 Computer-aided design and computer-aided manufacturing custom impression coping. resorbable, blast media surfaced dental implant was chosen (Inclusive; Glidwell Corp), and full thickness labial and lingual flaps were reflected (Fig. 4). 5. Confirm adequate primary stability (40 Ncm) and hand tighten the CAD/ CAM interim abutment on the implant. Place the polyvinyl siloxane impression material (Exafast NDS; GC America Inc) into the occlusal access hole. 6. Evaluate implant stability at the day of surgery with a Periotest device (Periotest; Siemens). For this patient, this was recorded as e1, consistent with adequate implant stability.38-40 7. Reline the CAD/CAM interim crown with autopolymerized acrylic resin (Alike; GC America Inc) after applying a separating medium (Al Cote; Dentsply
-
Issue
-
2 Computer-aided design and computer-aided manufacturing interim abutment and crown. Intl) to the CAD/CAM interim abutment. The space between the CAD/CAM interim abutment and the crown was provided to compensate for inaccuracies in the implant position during surgery. 8. Trim the excess automolymerized acrylic resin material and confirm occlusal clearance at approximately 50 mm with 4 layers of shim stock (Occlusal registration strips; The Artus Corp). Evaluate the proximal contacts with a single layer of the shim stock. 9. Cement the CAD/CAM interim crown with noneugenol interim cement (TempBond; Kerr Corp). After removing the excess cement, suture the tissue with polytetrafluoroethylene white monofilament nonabsorbable suture (Cytoplast; Osteogenics Biomedical Inc) (Fig. 5). 10. Three months after surgery (Fig. 6), check the implant for stability with the Periotest device. For this patient, the Periotest measured e2, whereas radiographic evaluation revealed no pathosis, which thereby confirmed successful osseointegration of the dental implant. No probing greater than 4 mm was detected around the implant. 11. Remove the CAD/CAM interim abutment and crown, and evaluate the tissue (Fig. 7). The tissue seemed to have obtained contours compatible with the contours of the prospective definitive prosthesis. Hand tighten the CAD/CAM custom impression coping and make a definitive impression with polyvinyl siloxane impression material (Exafast NDS).
The Journal of Prosthetic Dentistry
12. Fabricate a CAD/CAM zirconia abutment bonded to a titanium insert41 and tighten it to 35 Ncm. Place polyvinyl siloxane impression material into the occlusal access hole. Also, make a cementable zirconia crown with similar contours to the interim restoration with data stored in the software. 13. Confirm the occlusion, proximal contacts, and esthetics, and cement the crown with resin modified glass ionomer cement (Rely-X Luting Cement; 3M ESPE) (Fig. 8).
DISCUSSION Placement of an interim restoration on the day of implant surgery offers esthetic, psychological, and functional advantages compared with the use of an interim removable prosthesis. It also eliminates second-stage surgery, which reduces patient discomfort and additional procedural cost. The soft tissue around the implants can heal according to the contours of the interim restoration.11,13,14,28,29 However, if the interim restoration is placed after the implant becomes osseointegrated, then an additional healing period of 3 to 8 weeks is needed for soft tissue healing.6,10,11,14 The protocol presented eliminated the period necessary for soft tissue healing and contouring because healing occurred concurrently with the implant. In the described technique, a CAD/ CAM impression coping was used to
Proussaefs
-
2014
3
4 Occlusal view, computer-aided design and computeraided manufacturing interim abutment in place.
6 Three-month postoperative evaluation.
5 Day of surgery, computer-aided design and computeraided manufacturing interim crown cemented, buccal view.
7 Four-month postoperatively, tissue healing, and contouring around implant.
8 Definitive cement-retained prosthesis. transfer soft tissue anatomy specimens to the laboratory before fabricating the definitive prosthesis. Others have suggested the use of the interim prosthesis while making the impression,28,36 fabricate a custom impression coping by placing autopolymerized acrylic resin
Proussaefs
around the impression coping,30,34,36 or use intraoral scanners.35 To the author’s best knowledge, no consensus exists as to which technique better transfers soft tissue architecture in the laboratory before the fabrication of a definitive prosthesis. The described technique may provide reduced
chair time by having the custom impression coping fabricated in advance before implant surgery. With the described technique, the operator also has the option of fabricating a screw-retained interim restoration, which would entail the use of acrylic resin material between the CAD/ CAM interim abutment and the crown after implant placement. In this situation, no separating medium would be placed between the interim abutment and the crown. After removing the excess acrylic resin material, the operator could open an occlusal access hole on the interim restoration, which transforms the interim prosthesis into a screw-retained restoration. The literature regarding complications of interim prosthesis placed on dental implants on the day of surgery is scarce. Oyama et al25 evaluated 17 consecutively
4
Volume treated root form dental implants of patients who received interim restoration on the day of surgery. In their study, 46% of the cement-retained interim crowns fractured and 15% experienced debonding of the acrylic resin veneer material. Therefore, patients need to be aware of these complications, and a thorough informed consent should include the relatively high possibility of those occurring.
SUMMARY The described technique offers an alternative method for fabricating interim restorations on dental implants. A prospective clinical study is needed to validate the use of the described technique.
REFERENCES 1. Adell R, Lekholm U, Rockler B, Branemark PI. A 15 year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416. 2. Jemt T, Lekholm U, Adell R. Osseointegrated implants in the treatment of partially edentulous patients: a preliminary study of 876 consecutively installed fixtures. Int J Oral Maxillofac Implants 1989;4:211-7. 3. Jemt T, Pettersson P. A 3-year follow-up study on single implant treatment. J Dent 1993;21:203-8. 4. Moscovitch MS, Saba S. The use of a provisional restoration in implant dentistry: a clinical report. Int J Oral Maxillofac Implants 1996;11:395-9. 5. Capp NJ. The diagnostic use of provisional restorations. Restorative Dent 1985;1:94-8. 6. Neale D, Chee WW. Development of implant soft tissue emergence profile: a technique. J Prosthet Dent 1994;71:364-8. 7. Breeding LC, Dixon DL. Transfer of gingival contours to a master cast. J Prosthet Dent 1996;75:341-3. 8. Saba S. Anatomically correct soft tissue profiles using fixed detachable provisional implant restorations. J Can Dent Assoc 1997;63:767-70. 9. Sze AJ. Duplication of anterior provisional fixed partial denture for the final restoration. J Prosthet Dent 1992;68:220-3. 10. Proussaefs P. The use of healing abutments for an implant supported fixed partial denture. J Prosthet Dent 2002;87:333-5. 11. Biggs WF. Placement of a custom implant provisional restoration at the second-stage surgery for improved gingival management: a clinical report. J Prosthet Dent 1996;75:231-3. 12. Listgarten MA, Lang NP, Schroeder HE, Schroeder A. Periodontal tissues and their counterparts around endosseous implants. Clin Oral Implants Res 1991;2:1-19.
13. Daftary F, Bahat O. Prosthetically formulated natural esthetics in implant prostheses. Pract Periodontics Aesthet Dent 1994;6:75-83. 14. Lewis S. Anterior single-tooth implant restorations. Int J Periodontics Restorative Dent 1995;15:31-41. 15. Branemark PI. Osseointegration and its experimental background. J Prosthet Dent 1983;50:399-410. 16. Levkove M, Beals R. Immediate loading of cylinder Implants with overdentures in the mandibular symphisis: the titanium plasma-spray screw system. J Oral Implantol 1990;4:265-70. 17. Chiapasco M, Gatti C, Rossi E, Haefliger W, Markwalder TH. Implant-retained mandibular overdentures with immediate loading. Clin Oral Implants Res 1997;8:48-57. 18. Schnitman P, Wohrle P, Rubenstein J. Immediate fixed interim prostheses supported by two-stage threaded implants: methodology and results. J Oral Implantol 1990;16: 96-105. 19. Schnitman P, Wohrle P, Rubenstein J, DaSilva J, Wang NH. Ten-year results for Branemark implants immediately loaded with fixed prostheses at implant placement. Int J Oral Maxillofac Implants 1997;12:495-503. 20. Tarnow DP, Emtiaz S, Classi A. Immediate loading of threaded implants at stage 1 surgery in edentulous arches: ten consecutive case reports with 5-year data. Int J Oral Maxillofac Implants 1997;3:319-24. 21. Randow K, Ericsson I, Nilner K, Petersson A, Glantz PO. Immediate functional loading of Branemark dental implants. An 18-month clinical follow-up study. Clin Oral Impl Res 1999;10:8-15. 22. Ji TJ, Kan JY, Rungcharassaeng K, Roe P, Lozada JL. Immediate loading of maxillary and mandibular implant-supported fixed complete dentures: a 1- to 10-year retrospective study. J Oral Implantol 2012;38: 469-76. 23. Malo P, de Araujo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of all-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc 2011;142:310-20. 24. Gomes A, Lozada J, Caplanis N, Kleinman A. Immediate loading of a single hydroxyapatite-coated threaded root form implant: a clinical report. J Oral Implantol 1998;24:159-66. 25. Oyama K, Kan JY, Rungcharassaeng K, Lozada J. Immediate provisionalization of a 3.0-mm-diameter implants replacing single missing maxillary and mandibular incisors: 1year prospective study. Int J Oral Maxillofac Implants 2012;27:173-80. 26. Ross S, Pette GA. Immediate implant placement and provisionalization using a customized anatomic temporary abutment (CATA) to achieve gingival marginal stability. Compendium 2013;34:344-50. 27. Babushkin JA. Restorative responsibilities for achieving exceptional implant esthetics. Compendium 2013;34:418-23. 28. Proussaefs P, Lozada J. Immediate loading of hydroxyapatite-coated implants at maxillary premolar area: three-year results of a pilot study. J Prosthet Dent 2004;91:228-33.
The Journal of Prosthetic Dentistry
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29. Proussaefs P, Kan J, Lozada J, Kleinman A, Farnos A. Effects of immediate loading with threaded hydroxyapatite-coated root-form implants on single premolar replacements: a preliminary report. Int J Oral Maxillofac Implants 2002;4:567-72. 30. Kan JY, Rungcharassaeng K, Lozada J. Immediate placement and provisionalization of maxillary anterior single implants: 1-year prospective study. Int J Oral Maxillofac Implants 2003;18:31-9. 31. Balshi TJ, Wolfinhger GJ, Wulc D, Balshi SF. A prospective analysis of immediate provisionalization of single implants. J Prosthodont 2011;20:10-5. 32. Abboud M, Koeck B, Stark H, Wahl G, Paillon R. Immediate loading of single-tooth implants in the posterior region. Int J Oral Maxillofac Implants 2005;20:61-8. 33. Bruno V, O’Sullivan D, Badino M, Catapano S. Preserving soft tissue after placing implants in fresh extraction sockets in the maxillary esthetic zone and a prosthetic template for interim crown fabrication: a prospective study. J Prosthet Dent 2014;11:195-202. 34. Noh K, Kwon KR, Kim HS, Kim DS, Pae A. Accurate transfer of soft tissue morphology with interim prosthesis to definitive cast. J Prosthet Dent 2014;111:159-62. 35. Lin WS, Harris BT, Morton D. Use of implant-supported interim restorations to transfer periimplant soft tissue profiles to a milled polyurethane definitive cast. J Prosthet Dent 2013;109:333-7. 36. Man Y, Qu Y, Dam HG, Gong P. An alternative technique for the accurate transfer of periimplant soft tissue contour. J Prosthet Dent 2013;109:135-7. 37. Koutouzis T, Neiva R, Nonhoff J, Lundgren T. Placement of implants with platformswitched Morse taper connections with the implant-abutment interface at different levels in relation to the alveolar crest: a short-term (1-year) randomized prospective controlled clinical trial. Int J Oral Maxillofac Implants 2013;28:1553-63. 38. Olive J, Aparicio C. Periotest method as a measure of osseointegrated oral implant stability. Int J Oral Maxillofac Implants 1990;5:390-400. 39. Teerlinck J, Quirynen M, Darius P, van Steenberghe D. Periotest: an objective clinical diagnosis of bone apposition towards implants. Int J Oral Maxillofac Implants 1991;6:55-61. 40. Elias J, Brunski JB, Scarton HA. A dynamic modal testing technique for noninvasive assessment of bone-dental implant interfaces. Int J Oral Maxillofac Implants 1996;11:728-34. 41. Kim JS, Raigrodski AJ, Flinn BD, Rubenstein JE, Chung KH, Mancl LA. In vitro assessment of three types of zirconia implant abutments under static load. J Prosthet Dent 2013;109:255-63. Corresponding author: Dr Periklis Proussaefs 3585 Telegraph Road, Suite no. C Ventura, CA 93003 E-mail: [email protected] Copyright ª 2014 by the Editorial Council for The Journal of Prosthetic Dentistry.
Proussaefs
in accordance with the acquired soft tissue morphology. The purpose of the current technique report was to describe a method for the immediate loading of single root form implants with a computer-assisted design and computer-assisted manufacturing (CAD/ CAM) interim restoration.
TECHNIQUE 1. Evaluate the tissue around the edentulous area for signs or symptoms of pathosis (Fig. 1). Make complete arch preliminary impressions preoperatively from the patient’s maxillary and mandibular arches by using polyvinyl siloxane impression material (Silgimix; Sultan Healthcare). Make an interocclusal record with polyvinyl siloxane occlusal registration material (Exabite II NSD; GC America Inc) at the maximum intercuspation position. In addition, after providing local anesthesia, map the alveolar ridge by using an endodontic file with a rubber stop.37 With this technique, the thickness of the soft tissue is measured around the area of the prospective implant surgery. 2. Scan the impressions (D700 scanner; 3Shape) and simulate the definitive prosthesis with the provided software. The computer software, which is incorporated into the scanner, allows the size and shape of each component to be designed digitally by
Assistant Professor, Advance Education Program in Implant Dentistry.
Proussaefs
using precise measurements. With the contours of the definitive prosthesis as reference, fabricate a custom interim abutment from a polymethyl methacrylate (PMMA) block with a milling machine (TS150 Milling Solution; IOS Technologies). An interim crown also can be milled from a PMMA block according to the computer-designed contours of the definitive prosthesis (Fig. 2). Design the interim crown to be slightly in infraocclusion and to provide a relief space between the interim abutment and the crown. Position the margins of the interim abutment according to the thickness of the soft tissue measured during ridge mapping. The goal is to position the margins 0.5 mm subgingivally on the facial aspect of the restoration for good esthetics so that the interim abutmente crown transition line is not visible. Fabricate the interim abutment and crown in the laboratory before implant surgery is scheduled. 3. Fabricate a CAD/CAM custom impression coping from a PMMA block (Fig. 3). The CAD/CAM interim crown can be evaluated on the diagnostic stone cast to confirm ideal contours, contact areas, and esthetics (Fig. 4). 4. Place the dental implant with the patient under local anesthesia and with the aid of a surgical stent and copious saline solution irrigation. For this patient, a threaded, root form,
2
Volume
1 Preoperative evaluation, occlusal view.
3 Computer-aided design and computer-aided manufacturing custom impression coping. resorbable, blast media surfaced dental implant was chosen (Inclusive; Glidwell Corp), and full thickness labial and lingual flaps were reflected (Fig. 4). 5. Confirm adequate primary stability (40 Ncm) and hand tighten the CAD/ CAM interim abutment on the implant. Place the polyvinyl siloxane impression material (Exafast NDS; GC America Inc) into the occlusal access hole. 6. Evaluate implant stability at the day of surgery with a Periotest device (Periotest; Siemens). For this patient, this was recorded as e1, consistent with adequate implant stability.38-40 7. Reline the CAD/CAM interim crown with autopolymerized acrylic resin (Alike; GC America Inc) after applying a separating medium (Al Cote; Dentsply
-
Issue
-
2 Computer-aided design and computer-aided manufacturing interim abutment and crown. Intl) to the CAD/CAM interim abutment. The space between the CAD/CAM interim abutment and the crown was provided to compensate for inaccuracies in the implant position during surgery. 8. Trim the excess automolymerized acrylic resin material and confirm occlusal clearance at approximately 50 mm with 4 layers of shim stock (Occlusal registration strips; The Artus Corp). Evaluate the proximal contacts with a single layer of the shim stock. 9. Cement the CAD/CAM interim crown with noneugenol interim cement (TempBond; Kerr Corp). After removing the excess cement, suture the tissue with polytetrafluoroethylene white monofilament nonabsorbable suture (Cytoplast; Osteogenics Biomedical Inc) (Fig. 5). 10. Three months after surgery (Fig. 6), check the implant for stability with the Periotest device. For this patient, the Periotest measured e2, whereas radiographic evaluation revealed no pathosis, which thereby confirmed successful osseointegration of the dental implant. No probing greater than 4 mm was detected around the implant. 11. Remove the CAD/CAM interim abutment and crown, and evaluate the tissue (Fig. 7). The tissue seemed to have obtained contours compatible with the contours of the prospective definitive prosthesis. Hand tighten the CAD/CAM custom impression coping and make a definitive impression with polyvinyl siloxane impression material (Exafast NDS).
The Journal of Prosthetic Dentistry
12. Fabricate a CAD/CAM zirconia abutment bonded to a titanium insert41 and tighten it to 35 Ncm. Place polyvinyl siloxane impression material into the occlusal access hole. Also, make a cementable zirconia crown with similar contours to the interim restoration with data stored in the software. 13. Confirm the occlusion, proximal contacts, and esthetics, and cement the crown with resin modified glass ionomer cement (Rely-X Luting Cement; 3M ESPE) (Fig. 8).
DISCUSSION Placement of an interim restoration on the day of implant surgery offers esthetic, psychological, and functional advantages compared with the use of an interim removable prosthesis. It also eliminates second-stage surgery, which reduces patient discomfort and additional procedural cost. The soft tissue around the implants can heal according to the contours of the interim restoration.11,13,14,28,29 However, if the interim restoration is placed after the implant becomes osseointegrated, then an additional healing period of 3 to 8 weeks is needed for soft tissue healing.6,10,11,14 The protocol presented eliminated the period necessary for soft tissue healing and contouring because healing occurred concurrently with the implant. In the described technique, a CAD/ CAM impression coping was used to
Proussaefs
-
2014
3
4 Occlusal view, computer-aided design and computeraided manufacturing interim abutment in place.
6 Three-month postoperative evaluation.
5 Day of surgery, computer-aided design and computeraided manufacturing interim crown cemented, buccal view.
7 Four-month postoperatively, tissue healing, and contouring around implant.
8 Definitive cement-retained prosthesis. transfer soft tissue anatomy specimens to the laboratory before fabricating the definitive prosthesis. Others have suggested the use of the interim prosthesis while making the impression,28,36 fabricate a custom impression coping by placing autopolymerized acrylic resin
Proussaefs
around the impression coping,30,34,36 or use intraoral scanners.35 To the author’s best knowledge, no consensus exists as to which technique better transfers soft tissue architecture in the laboratory before the fabrication of a definitive prosthesis. The described technique may provide reduced
chair time by having the custom impression coping fabricated in advance before implant surgery. With the described technique, the operator also has the option of fabricating a screw-retained interim restoration, which would entail the use of acrylic resin material between the CAD/ CAM interim abutment and the crown after implant placement. In this situation, no separating medium would be placed between the interim abutment and the crown. After removing the excess acrylic resin material, the operator could open an occlusal access hole on the interim restoration, which transforms the interim prosthesis into a screw-retained restoration. The literature regarding complications of interim prosthesis placed on dental implants on the day of surgery is scarce. Oyama et al25 evaluated 17 consecutively
4
Volume treated root form dental implants of patients who received interim restoration on the day of surgery. In their study, 46% of the cement-retained interim crowns fractured and 15% experienced debonding of the acrylic resin veneer material. Therefore, patients need to be aware of these complications, and a thorough informed consent should include the relatively high possibility of those occurring.
SUMMARY The described technique offers an alternative method for fabricating interim restorations on dental implants. A prospective clinical study is needed to validate the use of the described technique.
REFERENCES 1. Adell R, Lekholm U, Rockler B, Branemark PI. A 15 year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416. 2. Jemt T, Lekholm U, Adell R. Osseointegrated implants in the treatment of partially edentulous patients: a preliminary study of 876 consecutively installed fixtures. Int J Oral Maxillofac Implants 1989;4:211-7. 3. Jemt T, Pettersson P. A 3-year follow-up study on single implant treatment. J Dent 1993;21:203-8. 4. Moscovitch MS, Saba S. The use of a provisional restoration in implant dentistry: a clinical report. Int J Oral Maxillofac Implants 1996;11:395-9. 5. Capp NJ. The diagnostic use of provisional restorations. Restorative Dent 1985;1:94-8. 6. Neale D, Chee WW. Development of implant soft tissue emergence profile: a technique. J Prosthet Dent 1994;71:364-8. 7. Breeding LC, Dixon DL. Transfer of gingival contours to a master cast. J Prosthet Dent 1996;75:341-3. 8. Saba S. Anatomically correct soft tissue profiles using fixed detachable provisional implant restorations. J Can Dent Assoc 1997;63:767-70. 9. Sze AJ. Duplication of anterior provisional fixed partial denture for the final restoration. J Prosthet Dent 1992;68:220-3. 10. Proussaefs P. The use of healing abutments for an implant supported fixed partial denture. J Prosthet Dent 2002;87:333-5. 11. Biggs WF. Placement of a custom implant provisional restoration at the second-stage surgery for improved gingival management: a clinical report. J Prosthet Dent 1996;75:231-3. 12. Listgarten MA, Lang NP, Schroeder HE, Schroeder A. Periodontal tissues and their counterparts around endosseous implants. Clin Oral Implants Res 1991;2:1-19.
13. Daftary F, Bahat O. Prosthetically formulated natural esthetics in implant prostheses. Pract Periodontics Aesthet Dent 1994;6:75-83. 14. Lewis S. Anterior single-tooth implant restorations. Int J Periodontics Restorative Dent 1995;15:31-41. 15. Branemark PI. Osseointegration and its experimental background. J Prosthet Dent 1983;50:399-410. 16. Levkove M, Beals R. Immediate loading of cylinder Implants with overdentures in the mandibular symphisis: the titanium plasma-spray screw system. J Oral Implantol 1990;4:265-70. 17. Chiapasco M, Gatti C, Rossi E, Haefliger W, Markwalder TH. Implant-retained mandibular overdentures with immediate loading. Clin Oral Implants Res 1997;8:48-57. 18. Schnitman P, Wohrle P, Rubenstein J. Immediate fixed interim prostheses supported by two-stage threaded implants: methodology and results. J Oral Implantol 1990;16: 96-105. 19. Schnitman P, Wohrle P, Rubenstein J, DaSilva J, Wang NH. Ten-year results for Branemark implants immediately loaded with fixed prostheses at implant placement. Int J Oral Maxillofac Implants 1997;12:495-503. 20. Tarnow DP, Emtiaz S, Classi A. Immediate loading of threaded implants at stage 1 surgery in edentulous arches: ten consecutive case reports with 5-year data. Int J Oral Maxillofac Implants 1997;3:319-24. 21. Randow K, Ericsson I, Nilner K, Petersson A, Glantz PO. Immediate functional loading of Branemark dental implants. An 18-month clinical follow-up study. Clin Oral Impl Res 1999;10:8-15. 22. Ji TJ, Kan JY, Rungcharassaeng K, Roe P, Lozada JL. Immediate loading of maxillary and mandibular implant-supported fixed complete dentures: a 1- to 10-year retrospective study. J Oral Implantol 2012;38: 469-76. 23. Malo P, de Araujo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of all-on-4 implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc 2011;142:310-20. 24. Gomes A, Lozada J, Caplanis N, Kleinman A. Immediate loading of a single hydroxyapatite-coated threaded root form implant: a clinical report. J Oral Implantol 1998;24:159-66. 25. Oyama K, Kan JY, Rungcharassaeng K, Lozada J. Immediate provisionalization of a 3.0-mm-diameter implants replacing single missing maxillary and mandibular incisors: 1year prospective study. Int J Oral Maxillofac Implants 2012;27:173-80. 26. Ross S, Pette GA. Immediate implant placement and provisionalization using a customized anatomic temporary abutment (CATA) to achieve gingival marginal stability. Compendium 2013;34:344-50. 27. Babushkin JA. Restorative responsibilities for achieving exceptional implant esthetics. Compendium 2013;34:418-23. 28. Proussaefs P, Lozada J. Immediate loading of hydroxyapatite-coated implants at maxillary premolar area: three-year results of a pilot study. J Prosthet Dent 2004;91:228-33.
The Journal of Prosthetic Dentistry
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29. Proussaefs P, Kan J, Lozada J, Kleinman A, Farnos A. Effects of immediate loading with threaded hydroxyapatite-coated root-form implants on single premolar replacements: a preliminary report. Int J Oral Maxillofac Implants 2002;4:567-72. 30. Kan JY, Rungcharassaeng K, Lozada J. Immediate placement and provisionalization of maxillary anterior single implants: 1-year prospective study. Int J Oral Maxillofac Implants 2003;18:31-9. 31. Balshi TJ, Wolfinhger GJ, Wulc D, Balshi SF. A prospective analysis of immediate provisionalization of single implants. J Prosthodont 2011;20:10-5. 32. Abboud M, Koeck B, Stark H, Wahl G, Paillon R. Immediate loading of single-tooth implants in the posterior region. Int J Oral Maxillofac Implants 2005;20:61-8. 33. Bruno V, O’Sullivan D, Badino M, Catapano S. Preserving soft tissue after placing implants in fresh extraction sockets in the maxillary esthetic zone and a prosthetic template for interim crown fabrication: a prospective study. J Prosthet Dent 2014;11:195-202. 34. Noh K, Kwon KR, Kim HS, Kim DS, Pae A. Accurate transfer of soft tissue morphology with interim prosthesis to definitive cast. J Prosthet Dent 2014;111:159-62. 35. Lin WS, Harris BT, Morton D. Use of implant-supported interim restorations to transfer periimplant soft tissue profiles to a milled polyurethane definitive cast. J Prosthet Dent 2013;109:333-7. 36. Man Y, Qu Y, Dam HG, Gong P. An alternative technique for the accurate transfer of periimplant soft tissue contour. J Prosthet Dent 2013;109:135-7. 37. Koutouzis T, Neiva R, Nonhoff J, Lundgren T. Placement of implants with platformswitched Morse taper connections with the implant-abutment interface at different levels in relation to the alveolar crest: a short-term (1-year) randomized prospective controlled clinical trial. Int J Oral Maxillofac Implants 2013;28:1553-63. 38. Olive J, Aparicio C. Periotest method as a measure of osseointegrated oral implant stability. Int J Oral Maxillofac Implants 1990;5:390-400. 39. Teerlinck J, Quirynen M, Darius P, van Steenberghe D. Periotest: an objective clinical diagnosis of bone apposition towards implants. Int J Oral Maxillofac Implants 1991;6:55-61. 40. Elias J, Brunski JB, Scarton HA. A dynamic modal testing technique for noninvasive assessment of bone-dental implant interfaces. Int J Oral Maxillofac Implants 1996;11:728-34. 41. Kim JS, Raigrodski AJ, Flinn BD, Rubenstein JE, Chung KH, Mancl LA. In vitro assessment of three types of zirconia implant abutments under static load. J Prosthet Dent 2013;109:255-63. Corresponding author: Dr Periklis Proussaefs 3585 Telegraph Road, Suite no. C Ventura, CA 93003 E-mail: [email protected] Copyright ª 2014 by the Editorial Council for The Journal of Prosthetic Dentistry.
Proussaefs
