Use of extracted anterior teeth as provisional restorations and surgical guide for immediate multiple implant placement: A clinical case report

Abstract

Objective The aim of this article is to describe the use of natural anterior teeth as a surgical guide to implant placement and provisional restoration for a young patient with root resorption of upper central incisors and left‐lateral incisor. Clinical considerations Achieving soft tissue esthetics is quite a challenge in implant dentistry. Here, a case of immediate implant placement using the natural teeth of the patient as an immediate provisional restoration, which achieves satisfactory results in terms of soft tissue architecture. Conclusions Post‐extraction implant placement in combination with immediate loading of dental implants has been evolving into an appropriate procedure for the treatment of partially edentulous anterior maxilla. Different techniques that include use of the own teeth as provisional implant supported restoration helps to maintain architecture of gingival contour, specially papilla. Clinical significance Natural architecture of anterior soft tissue is a big challenge in implant dentistry. Use of natural teeth as a surgical guide and provisional restorations might be helpful to obtain an optimal outcome.

A digital workflow for accurately and rapidly creating an immediate provisional restoration with natural emergence profile using extracted tooth

“…In the previous protocol for the use of extracted anterior tooth as immediate provisional restoration, clinicians needed to remove the tooth structure and then try to wear it in oral cavity repeatedly until a suitable place was obtained. 10,11,13 The patient's discomfort and bleeding increased in this situation. In this present case, the proposed digital protocol enabled the clinicians to prepare immediate restoration out of oral cavity and attach it to the implant just for one time at the end of the procedure.…”

“…Currently, different restorative materials such as auto‐polymerized acrylic resin, polymethyl methacrylate and resin composites are commonly used to create immediate provisional restorations 7,10,13 . However，because of the different characteristics of these restorative materials, their artificial surface roughness might increase the microbial adhesion to provisional restorations 23,24 .…”

“…But the natural tooth surface possesses ideal biocompatibility and can prevent the microbial adhesion to a certain extent. Moreover, the biocompatible structure of natural tooth might favor the development of a good soft tissue attachment 8–10 . In addition, patients would have a higher psychological acceptance of the provisional restoration created with their own teeth, which is conducive to the success of temporary restorations to final restorations.…”

“…However, the biocompatible structure of natural tooth might favor the development of a good soft tissue attachment 8,9 . Therefore, immediate implant placement after tooth extraction, using the extracted natural tooth as a provisional restoration can achieve the required emergence profile without additional adjustments, thus shortening the chair‐side time and inconvenience 10 . However, when preparing the height and insertion path for the provisional restoration attached to a temporary abutment, clinicians need to remove the tooth structure and then try to wear it in oral cavity repeatedly until a suitable place is obtained 11–13 .…”

“…10 However, when preparing the height and insertion path for the provisional restoration attached to a temporary abutment, clinicians need to remove the tooth structure and then try to wear it in oral cavity repeatedly until a suitable place is obtained. [11][12][13] This procedure is still time-consuming, and there is currently no reliable method that can attach teeth to temporary abutments precisely. Moreover, repeated try-in of restoration increases patient's discomfort and the risk of infection in implantation site.…”