An alternative method for restoring single-tooth implants.

Background: Having laboratory technicians prepare soft-tissue casts and implant abutments with or without concomitant removable temporary prostheses during the restorative phase of single-tooth replacement is an accepted practice. It can, however, result in functional and esthetic intraoral discrepancies.

Case Description: Single-tooth implants can be restored with crowns (like those for natural teeth) fabricated at a dental laboratory on casts obtained from final impressions of prepared implant abutments. In the case reported, the restorative dentist restored the patient's single-tooth implant after taking a transfer impression. He constructed a cast simulating the peri-implant soft tissue with final impression material and prepared the abutment on this model. His dental assistant then fabricated a fixed provisional restoration on the prepared abutment. At the patient's next visit, the dentist torqued the prepared abutment onto the implant, took a final impression and inserted the provisional restoration. A crown was made conventionally at the dental laboratory and cemented in place at the following visit.

Clinical Implications: This alternative method for restoring single-tooth implants enhances esthetics by more accurately simulating marginal gingival architecture. It also improves function by preloading the implant through fixed temporization after the dentist, rather than the laboratory technician, prepares the abutment to the dentist's preferred contours.