Reference Markers
Often, comprehensive implant therapy requires long-term temporization. When patients prefer fixed provisionalization, the security of a cemented provisional bridge accomplishes these goals.
These patients frequently require 3D radiographic evaluations. In-office CT scans obviate the need for additional appointments to hospitals or imaging centers. The reduction in radiation offered by these types of scanners is also beneficial. When selecting implant position(s) and dimensions, radiographic templates serve the purpose of “lining up” the implant via treatment planning software with a radiopaque reference point. Commonly, removable stents are worn while patients are scanned. The presence of a fixed, temporary bridge would require its removal for the insertion of a removable scanning appliance, and additional time for its re-cementation and possible repair from the removal process. One method of circumventing this is to incorporate radiopaque markers embedded within fixed, provisional restorations.
Tension-Free Sutures
The key to success with continuous sutures: The clinician must understand that a continuous loop or continuous locking suture is nothing more than one uninterrupted suture and therefore should only be placed when the surgical flap edges are freely mobile, meaning tension-free. Therefore, if the flap reflection is beyond the mucogingival junction, a mattress suturing technique must first be used to resist the muscle pull in that surgical area in order to render the flap edges tension-free. Do not confuse a continuous loop or continuous-lock technique with a mattress-suture technique. Only mattress sutures resist muscle pull, whereas continuous loop or continuous locking sutures do not.
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