Restoration of Immediate Temporary Crown Cases: Guidance?

Dr. P. asks:
I am just starting out with the restoration of dental implants placed by my surgeon. He recommends that we do some immediate temporary crown cases. He will placed the implant then sends the patient to me for restoration. Since we work in the same building this is not a problem. The patient just gets on the elevator. How do I make temporary crowns for this kind of situation? We use Nobel Biocare and I have bought some of their metal temporary crown cylinders. But I am really worried about making a temporary crown in a bloody field. I am also worried about catching the sutures in the acrylic. How do I contour the facial subgingival aspect of a temporary crown for a maxillary central incisor? My surgeon suggested that I make some ‘shell crowns’ and just reline these over the temporary cylinder. How do I do this?

3 Comments on Restoration of Immediate Temporary Crown Cases: Guidance?

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Dr.V
5/12/2009
use a piece of rubber dam to protect the site before you reline the crowns
Bill Baum
5/12/2009
It is good to use a shell crown for a single unit. For larger cases you can have the lab manufacture a splint on a pre-op cast then a hole can be drilled at the approx implant site. Either way the temp cylinder should be cut down to the occlusal height then intra-orally the shell is luted to the cylinder. After it is set the newly joined components are unscrewed and more acrylic is added extra-orally. This can then be refined to have a more ideal emergence profile without concern for trapping the sutures. Polish and deliver. The soft tissue will mature to the proper contour and will be appropriately positioned for the definitive restoration. Bill
Gerald Rudick
5/12/2009
Dr. P.....why are you playing with fire..... you will burn yourself and regret it. Just because the surgeon placed two implants, does not mean you have to load these implants immediately. You can mold some denture base repair material and attach a couple of the missing teeth with esthetic denture teeth... and make an immediate flipper. If you are inexperienced at implant prothodontics, you might cause some damage and regret it. You can try to make an immediate Maryland bridge and get good esthetics, without desturbing or interfering with the freshly placed implants. Gerald Rudick Montreal Canada

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