The Importance of Ovate Temporaries In Achieving Aesthetic Implant Restorations
One of the most difficult tasks in implant dentistry is obtaining esthetically pleasing soft tissue around implant retained crowns. Though many factors are involved in reaching this goal, few are more important than proper temporization of an extraction site.
Though more implants are being placed immediately following tooth extraction, allowing an extraction site to heal for 3-4 months with delayed implant placement still offers the most predictable result. In most cases where implant placement will be delayed, the patient requires a temporary prosthesis for esthetics. These appliances, when properly designed, can preserve and even improve the contours of the soft tissue where the permanent implant prosthesis will be placed. This applies to all temporary types -removable partial dentures, bonded natural crowns or denture teeth, and fixed partial dentures. The critical design feature is that the prosthetic teeth have convex apical contours allowing the soft tissue to “grow” around it. With a fixed partial denture, such a design would be called an ovate pontic.
Unfortunately, most dental labs typically make removable partial dentures with “saddle” type denture teeth. This occurs for two primary reasons – denture teeth are manufactured with a flat or concave apical contour, and gingival colored resin is usually placed around denture teeth to replace the gingival papillae. These traditional partial designs can obliterate the existing papillae and create a flat or convex edentulous ridge.
A properly designed temporary prosthesis will not impinge on the existing papillae, will allow room for soft tissue proliferation in embrasure spaces, and will be highly polished to resist food and bacteria accumulation. As the extraction site heals, material can be removed or added to the prosthesis to guide the soft tissue to the desired form.
When temporized properly, the healed extraction sites have the papillae preserved at the time of implant placement and the temporary prosthesis can continue to be utilized after minimal adjustment. This is far better than trying to reconstruct the papillae after the implant restoration is completed.
The next time you treatment plan an implant restoration, particularly one in the esthetic zone, request that your lab technician make a temporary prosthesis with ovate prosthetic teeth. By doing so, the soft tissue esthetics of your implant restorations will likely be improved.
The Palm Beach Center for Oral Surgery and Dental Implants providing quality care to Delray Beach, Boca Raton, Boynton Beach, and Palm Beach County. 561.900.9080 www.PasqualOMS.com