Screw retained Immediate implant temporary

Lab fabricates temporary crown with seating wings and hollow center
Temp abutment is seated and temp crown is tried on offer it to check for full seating
Once confirmed temp crown is luted to temp abutment intro-orally.
Entire screw retained temp is now removed, refined, and polished.
Dentistry today 2016 Sept Schnitman page 22

If using patient tooth or a prefab tooth

Seat temp PEEK abutment with cured bond layer or Ti cylinder with metal primer and cut so has occlusal clearance plus space for temporary.
Place tooth or prefab tooth into position, hollow out as needed.
Drill hole through occlusal so can see access to abutment screw.
Prepare inside of tooth for bonding. Etch, prime, bond natural or roughen and bond prefab.
Seat tooth back in postition
Place teflon tape in access
Place broken cotton applicator stick in access
Inject small amount of flowable into shell or tooth and cure
Remove stick and tape and unscrew as one piece
Add resin to the abutment/temp and let the shaping begin.
Try it in the mouth periodically to make sure you’re on the right track. Be sure it is under-contoured (even if own tooth)

If can’t use natural tooth but can use prefab or natural tooth for shape

Seat temp PEEK abutment with cured bond layer or Ti cylinder with metal
primer and cut so has occlusal clearance plus space for temporary.
Seat patient’s tooth, prefab tooth, or denture tooth over abutment (I’ll call tooth guide from now on). Hollow as needed to fully seat.
Drill hole through occlusal so can see access to abutment screw.
Plug the access hole with teflon tape and seat a broken short cotton applicator tip
Place cheap PVS, wax, or other undercut material in the undercuts IP. – IMPORTANT!!!
Take a putty over seated crown with cotton applicator in screw hole and one on facial.
Remove sticks, putty, and tooth guide.
Ensure putty picked up PVS undercut OR ensure undercuts still blocked out.
Seat putty back in place and cotton stick back in access
Inject bis-acryl into tooth area through facial hole and let set
Remove putty, stick, teflon tape, and unscrew temp abutment as one piece now
Add resin where needed to the abutment/temp and let the shaping begin.
Try it in the mouth periodically to make sure you’re on the right track.

If no tooth and can’t use a prefab as a guide Or to save a little op time

Lab work – Take impression and pour up in stone. Use denture tooth or wax up tooth.
Make a clear suck-down of the model.
On patient – Seat temp PEEK abutment with cured bond layer or Ti cylinder with metal
primer and cut so has occlusal clearance plus space for temporary.
Plug access with teflon tape and seat a broken short cotton applicator tip
Place cheap PVS, wax or other undercut material in the undercuts IP.
Lube the adjacent teeth with KY jelly or vaseline or place teflon tape against teeth.
Drill hole in facial to add bis-acryl and one in back for cotton applicator stick to allow access to screw.
Remove stick and seat suck-down and re-place cotton applicator stick back in access hole.
Inject bis-acryl into the matrix and allow it to set. This can be problem if any undercuts left!
Remove suck down, unscrew temp, remove and start shaping.
Add resin where needed to the abutment/temp and let the shaping begin.
Try it in the mouth periodically to make sure you’re on the right track.