Fabrication and Use of a Customized Provisional Composite Abutment in Dental Practice

INTRODUCTION: Reducing the time of implant integration and the period of prosthetics is an important task of dentistry since this leads to improved quality of life and successful rehabilitation of the patient. Therefore, currently, there is an intensely increased interest in immediate or early loading of the implant, when certain parameters of primary implant stability in the bone tissue are achieved. MATERIALS AND METHODS: The materials used to perform the procedure for placement of a customized provisional composite abutment were a provisional prefabricated abutment with a retention grip for the composite; aluminum oxide powder with a particle size of 27 μm for better adhesion of the composite, with which the retention grip of the provisional abutment is coated; 3M Single Bond Universal light-curing adhesive applied to the provisional abutment; and Filtek Bulk Fill 3M composite including a low-viscosity radiopaque nanocomponent and ytterbium trifluoride filler with a particle size of 0.01–3.5 nm. Methods used in this study were as follows: fabrication technique using the Cervico system for a customized provisional composite abutment; sandblasting of the provisional abutment using the apparatus RONDOFLEX (KERR); light polymerization of low-viscosity composite using Demi Ultra Kerr lamp (luminous flux power not less than 1100 mW/cm(2)); and radiographic control of the abutment fit in the implant. RESULTS: The surgical and orthopedic treatment of 20 patients was performed using this technique. The control group consisted of 11 patients with similar pathology, in whose surgery the fabrication of a provisional prosthesis was used. As a result, it was possible to form a gingival profile, in comparison with the control group, to accelerate mucogingival and bone integration, as well as to quickly carry out orthopedic rehabilitation of the patient. The average value of the time required for the final formation of soft tissues for prosthetics in patients in the experimental group was significantly lower than those in the comparison group (p=0.007 and p=0.028, respectively). In most clinical cases, there is no need for surgery on soft tissues, which eliminates the possibility of additional traumas. CONCLUSIONS: The use of a promising technology for the fabrication of a crown on the implant and a customized provisional composite abutment significantly reduced the period of orthopedic rehabilitation of the patient. Immediate implantation with a customized provisional composite abutment completely forms the gingival profile, reduces the risk of microbial contamination in the area of bone formation, minimizes soft tissue ischemia, and accelerates the processes of mucogingival and bone integration around the implant.