Provisional Implants: A Clinical Prospective Study in 45 Patients, from Implant Placement to Delivery of the Final Bridge

Abstract

Protocols for submerged healing of dental implants often require the patient to have no teeth until suture removal and to wear a removable prosthesis during the remaining healing period. This may be inconvenient for the patient, and healing may be influenced negatively by the removable prosthesis. The aim of the present prospective clinical study was to evaluate the use of provisional implants (PIs) to provide patients with a provisional fixed bridge during the healing of permanent implants. Twenty female and 25 male patients were consecutively included in the study. The 45 patients were treated for either partial (16 patients) or total (29 patients) edentulism in the maxilla. The permanent implants were placed first; as many PIs as possible were then installed between the permanent implants. After suturing, impressions from which to manufacture provisional bridges (to be cemented to the PIs) were taken. The patients were monitored with clinical and radiographic follow-up from implant placement to delivery of the final prosthesis. Five (2.2%) of the 230 permanent Brånemark System implants (Nobel Biocare AB, Gothenburg, Sweden) did not integrate. None of the failures could be related to the presence of PIs between the permanent implants. Seven PIs failed during the observation period. In addition, 17 (9%) of the 192 PIs showed mobility at the second-stage surgery although they had supported the provisional bridges without clinical symptoms. Forty-four of 45 patients showed stabile PI bridges at the time of second-stage surgery. Based on our experiences we concluded that provisional implants can be successfully used to provide patients with a fixed provisional bridge during the healing of permanent implants.