Fabrication of a Single-Tooth Implant Provisional Restoration: A Visual Essay

Single-tooth implants in the esthetic zone usually require a provisional restoration. The fabrication of a single-tooth implant-supported restoration requires a careful step-by-step approach to deliver a restoration that will assist the process of soft-tissue sculpting.

Here is a multi-step process showing the fabrication sequence of a screw-retained single-tooth implant provisional restoration of a lateral incisor.

RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.1
Figure 1: Clinical situation before making the impression for provisional fabrication.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.2
Figure 2: Impression coping is secured into the implant and ready for radiographic verification.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.3
Figure 3: An impression utilizing polyvinylsiloxane is made, and an implant replica is secured onto the implant. Soft-tissue moulage is carefully injected around the analog.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.4
Figure 4: A master cast is obtained by securing an analog into the impression coping in the impression and pouring it with stone and a soft-tissue moulage in the area of the implant.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.5
Figure 5: A temporary titanium abutment is secured, and the height is customized.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.6
Figure 6: A full contour wax-up is made on top of the abutment.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.7
Figure 7: A silicone matrix is made from the wax-up.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.8
Figure 8: The temporary abutment is opaqued and inserted back in place.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.9
Figure 9: Acrylic resin is injected into the silicone matrix and seated on the cast to obtain the full contoured provisional.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.10
Figure 10: A contour is added at the emergence profile area to influence the sculpting of the tissue. It is then polished using a silicone wheel.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.11
Figure 11: The finalized single-tooth implant-supported screw-retained provisional restoration.
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.12
Figure 12: The facial aspect of the provisional is in place, but we are still waiting for the soft-tissue maturing of the mesial papilla.  
RicardoMitrani fabrication of a single tooth implant provisional restoration Fig.13
Figure 13: An occlusal view of the screw-retained provisional restoration.

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By: Ricardo Mitrani
Date: July 18, 2018


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