Timing implant provisionalization: Decision-making and systematic workflow.

OBJECTIVE: Provisionalization is an important step to achieve esthetic results in implant cases, and many different techniques for provisional restoration fabrication have been described. However, depending on the clinical scenario, the provisionalization strategy will require different approaches and timing. The clinician should modify the provisional restorations efficiently to reduce the number of disconnections from the implant, as repeated disconnections may have biological consequences. This article aims to schematize different scenarios requiring implant provisionalization and propose strategies to help the clinician condition the peri-implant tissues, respecting perio-prosthodontic fundamentals for soft tissue, biological, and esthetic stability. CLINICAL CONSIDERATIONS: The clinical outcomes of modern implant therapy aim to achieve results that emulate natural dentition. Different scenarios may require adjunct therapy, including hard- and soft-tissue grafting, which complicates treatment. The provisionalization strategy will vary depending on the initial condition of the tissues, the need for reconstructive procedures, and the timing of implant placement. Selecting the right strategy based on the case type is necessary to reduce treatment time and complications associated with inadequate prosthetic handling of the soft tissues. CLINICAL SIGNIFICANCE: Proper emergence profile conditioning through provisional restorations will allow for biologically sound and esthetically pleasing outcomes in implant restorations.

The biotransfer approach: The use of an alveolar cast die for the fabrication of the emergence profile on implant-supported interim restorations.

Maintaining natural-looking soft tissues around dental implants is one of the biggest challenges for the restorative team. To achieve this, the emergence profile of the preexisting teeth in the alveolus can be emulated rather than conditioning the soft tissue architecture arbitrarily. The biotransfer technique uses an interim restoration with a biologically driven emergence profile fabricated before the implant surgery.

The utilization of snap-on provisionals for dental veneers: From an analog to a digital approach.

OBJECTIVE: There are multiple treatment options to enhance a patient's smile, from conservative bleaching procedures to composite resins, porcelain veneers, or full-coverage crowns. Treating patients with porcelain veneers is a commonly used approach in esthetic dentistry. Provisional restorations for veneers can be time-consuming to make and difficult to retain. This article illustrates a technique for fabricating indirect snap-on provisional restorations for veneer cases, describing both analog and digital approaches. CLINICAL CONSIDERATIONS: The present article presents an alternative provisionalization technique using snap-on restorations for dental veneers. Application of these techniques will allow for ease of cleansability by the patient leading to healthier soft tissues before the final cementation. Delivery of veneers is more predictable with healthy soft tissue, as bleeding and inflammation may affect the bonding process. CONCLUSIONS: This technique is an effective provisionalization option in most veneer cases. This approach seems to be well accepted by patients and a good alternative in helping to maintain optimal gingival health with interim restorations before delivery. CLINICAL SIGNIFICANCE: The use of snap-on provisionals for veneer restorations will allow the clinician to have an efficient technique with better tissue response before cementation. This prevents inflammation and facilitates a controlled delivery process.

Efeito da intensidade de fontes de luz e barreiras de cerâmica na microdureza de cimento resinoso dual / Effect of intensity of light sources and barriers in ceramic hardness of dual-cured cement

Introdução: O cimento resinoso dual é o principal material para cimentação de cerâmicas. Contudo, fatores, como fonte de luz, podem influenciar no desempenho do cimento. Objetivo: Avaliar a influência de duas fontes de luz de diferentes intensidades sobre a microdureza de um cimento resinoso quando fotoativado sob diferentes cerâmicas. Material e método: Foram fotoativados 40 espécimes de cimento resinoso dual (10 mm × 1,0 mm) por meio de duas fontes de luz LED, com intensidades de 1.000 mW/cm² e 800 mW/cm² durante 40 segundos, sob cerâmicas (15 mm × 2 mm) à base de zircônia, espinélio MgAl2O4 e dissilicato de lítio. No grupo controle, foi utilizada uma placa de vidro de mesma dimensão. As amostras tiveram a superfície regularizada com lixa d`água (600 e 1200). Após armazenagem a seco no escuro (24 h), foram realizadas as medidas de microdureza Vickers (HMV Shimadzu - 50g/10 segundos). Os dados foram submetidos à Anova fatorial e ao teste de Tukey com nível de significância de 5%. Resultado: O cimento polimerizado apresentou valor médio de microdureza e desvio padrão para o grupo controle de 43,9±1,5 e 43,4±1,3, para as intensidades de 1.000 mW/cm2 e 800 mW/cm2, respectivamente. O menor valor de microdureza do cimento foi observado para a cerâmica à base de espinélio MgAl2O4, polimerizado a 800 mW/cm², com valor de 34,3±3,3.