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23 Implants > 8/30 - Provisionals During Implant Healing > Flashcards

8/30 - Provisionals During Implant Healing Flashcards

1
Q

are provisionals arranged or existing for the present with the possibility to be changed later

A

YES

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2
Q

what is the objective of provisionals

A

esthetic and functional replacement of missing tooth structure or teeth fora limited period of time

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3
Q

what are the provisional options during healing

A
  1. essix retainer
  2. interim removable partial denture
  3. fixed tooth-supported provisional
  4. implant provisional
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4
Q

when are essix retainers intended for use

A

initial post-surgical phase

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5
Q

how many weeks to use essix

A

</= 3 weeks

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6
Q

are essix retainers tooth borne

A

yes

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7
Q

advantages of essix retainer

A
  1. no pressure on tissue during initial healing
  2. inexpensive and quick fabrication
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8
Q

disadvantages of essix retainer

A
  1. short-term
  2. esthetics only - not functional so should be not eat with it
  3. removable
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9
Q

what vacuuform material for essix

A

0.040”

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10
Q

when preparing the essix for scalloping, what do you mark

A

cervical aspect of CEJ

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11
Q

is it better to destroy cast or distort vacuum material

A

destroy cast

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12
Q

steps for cuttting essix

A
  1. acrylic bur
  2. scotch brite
  3. felt wheel
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13
Q

where to place coe-sep

A

in area of composite tooth of stone model

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14
Q

is it ok if there is space between cast and composite? why?

A

yes because that is where tissue fills in

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15
Q

what to tell pt when delivering essix retainer

A
  1. where for esthetics only
  2. no eating with it on
  3. brush before inserting again because that’s where bacteria harbors
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16
Q

what is know to patients as flipper

A

interim partial denture

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17
Q

materials in interim partial denture

A

acrylic, denture teeth, wrought wire clasps

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18
Q

what are interim partial dentures intended for

A

post-surgical phase after initial healing

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19
Q

how long can interim partial denture last

A

> /= 3 weeks-yearsa

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20
Q

advantages of interims

A
  1. esthetic and functional
  2. space maintenance
  3. inexpensive and quick fabrication
  4. repairable
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21
Q

disadvantages of interims

A
  1. pressure on surrounding hard and soft tissues and surgical site
  2. removable
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22
Q

when are fixed tooth-supported provisionals indicated

A

in situations when adjacent tooth/teeth will have definitive full coverage restorations

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23
Q

are fixed tooth supported materials tooth born

A

yes

24
Q

what materials can be used for fixed tooth supported provisional

A

acrylic (Jet or Trim)
Bis-acryl (Integrity)

25
Q

are fixed tooth-supported provisionals intended for post surgical healing

A

yes

26
Q

advantages of fixed tooth supported provisionals

A
  1. no pressure on tissue during initial healing
  2. fixed
  3. esthetic
  4. tissue sculpting (around area of pontix)
27
Q

disadvantages of tooth-supported provisional

A
  1. maintenance/fracture/debonding
  2. caries risk
28
Q

are implant provisionals tooth borne?

A

NO! implant-borne!

29
Q

materials of implant provisional

A
  1. plastic or titanium temporary abutment
  2. acrylic
  3. bis-acryl
  4. composite
  5. denture tooth
30
Q

advantages of implant provisional

A
  1. fixed
  2. tissue support
  3. identity implant and/or angulation problems
31
Q

disadvantages of implant provisional

A
  1. esthetic challenges
  2. no removal during healing
  3. implant vulnerability
  4. no functional contribution
    (all above are immediate/early)
  5. increased cost
32
Q

what are implant provisionals intended for

A
  1. post surgical healing
  2. soft tissue development
  3. patient management
  4. predict prosthetic form/contour
  5. identify implant angulation problems
  6. evaluate questionable implants
33
Q

different levels of implant provisional protocols

A
  1. immediate
  2. early
  3. conventional/delayed
34
Q

when level: implants placed within 1 week of placement

A

immediate

35
Q

what level: implant in function between 1 week and 2 months after placement

A

early

36
Q

what level: plant in function after 2 months healing

A

conventional/delayed

37
Q

immediate implant provisionals are used only in what situations

A
  1. adequate primary stability
  2. no centric, eccentric, or protrusive contacts
  3. esthetic gain outweighs risks associated w/ immediate loading protocols
38
Q

what is the initial fixation of implnt sufficiently strong to withstand disloding forces

A

primary stability

39
Q

where is primary stability mechanical in nature

A
  1. osteotomy
  2. bone density
  3. implant geometry
  4. thread pattern
40
Q

does a more or less aggressive thread pattern bind more tightly to bone

A

more

41
Q

what is the minimum insertion torque for primary stability? what is preferred

A

minimum: 30-35 Ncm
preferred: 40-45 Ncm

42
Q

what test uses a meter and probe placed on implant to see how tight it is on bone

A

ISQ test

Implant Stability Quotient

43
Q

are we always able to do an immediate implant provisional

A

NO

44
Q

when can you not do implant provisional

A
  1. lack primary stability
  2. parafunctional habits
  3. unable to eliminate centric/eccentric/protrusive contacts
  4. non-compliant patient
  5. non-esthetic zone
  6. esthetic gain deos not outweight risk of implant complications
45
Q

provisional prostheses should be ___, ___, and ___ to last throughout the duration of tx

A

strong, durable, and esthetic

46
Q

in clinic, when working on ANTERIOR CASE, implant tx plans should include what?

A
  1. essix retainer (</= 3 weeks)
  2. interim partial denture (>/= 3 weeks- second stage)
  3. interim abutment (2nd stage-definitive restoration placement aka provisional implant crown)
47
Q

after patient signs implant treatment plan, what codes are moved to COMPLETE

A
  1. surgical guide
  2. treatment plan
48
Q

after patient signs implant treatment plan, what codes are moved to IN PROCESS

A
  1. essix retainer
  2. interim partial denture
49
Q

prior to surgery appointment what must be done

A
  1. create essix retainer and wax up
  2. create interim partial denture
50
Q

when drawing design for interim partial denture, what color is acrylic and what color is wrought wire

A

acrylic = red
wrought wire = blue

51
Q

when creating interim partial denture, how do you denote on a cast that a tooth is to be extracted

A

“x” on tooth

52
Q

what to do on day of implant surgery

A
  1. deliver essix retainer
  2. index implants for provisional implant crown fabrication
53
Q

on the day of implant surgery, when can you index implants for provisional implant crown fabrication?

A

as long as implant is stable

54
Q

on day of implant surgery, when codes to you place in COMPLETE

A

surgical codes and essix retainer

55
Q

on day of implant surgery, when codes to you place in IN PROCESS

A

interim abutment

56
Q

when completing records/ note on day of surgery what must you do

A

be specific of the implant diameter and length placed

e.g., 4.8x11 S and 4.811P are very different and affect how they are restored

23 Implants (9 decks)

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