McArdle B F, Clarizio L F
J Am Dent Assoc. 2001 Sep;132(9):1269-73; quiz 1318-9. doi: 10.14219/jada.archive.2001.0370.
Having laboratory technicians prepare soft-tissue casts and implant abutments with or without concomitant removable temporary prostheses during the restorative phase of single-tooth replacement is an accepted practice. It can, however, result in functional and esthetic intraoral discrepancies.
Single-tooth implants can be restored with crowns (like those for natural teeth) fabricated at a dental laboratory on casts obtained from final impressions of prepared implant abutments. In the case reported, the restorative dentist restored the patient's single-tooth implant after taking a transfer impression. He constructed a cast simulating the peri-implant soft tissue with final impression material and prepared the abutment on this model. His dental assistant then fabricated a fixed provisional restoration on the prepared abutment. At the patient's next visit, the dentist torqued the prepared abutment onto the implant, took a final impression and inserted the provisional restoration. A crown was made conventionally at the dental laboratory and cemented in place at the following visit.
This alternative method for restoring single-tooth implants enhances esthetics by more accurately simulating marginal gingival architecture. It also improves function by preloading the implant through fixed temporization after the dentist, rather than the laboratory technician, prepares the abutment to the dentist's preferred contours.
在单颗牙种植修复阶段,让实验室技术人员制作软组织模型和种植基台,无论是否同时制作可摘临时假牙,都是一种公认的做法。然而,这可能会导致口腔内出现功能和美观方面的差异。
单颗牙种植体可以用在牙科实验室根据种植基台最终印模制作的牙冠(类似于天然牙的牙冠)进行修复。在本病例中,修复牙医在取转移印模后为患者的单颗牙种植体进行修复。他用最终印模材料制作了一个模拟种植体周围软组织的模型,并在这个模型上制备基台。然后他的牙科助手在制备好的基台上制作了一个固定临时修复体。在患者下次就诊时,牙医将制备好的基台拧到种植体上,取最终印模并插入临时修复体。牙冠在牙科实验室按常规制作,并在下次就诊时粘固到位。
这种修复单颗牙种植体的替代方法通过更准确地模拟边缘牙龈结构来提高美观度。在牙医而非实验室技术人员将基台制备成牙医喜欢的轮廓后,通过固定临时修复对种植体进行预加载,还能改善功能。