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16 CASE STUDY THE TEMPORARY RESTORATION AS AN IMPORTANT COMPONENT OF IMPLANTOLOGICAL REHABILITATION Dr. Thorsten Wilde, Berlin The strategies of modern implantology are technically mature and frequently clinically tested, both in the field of osseointegration, as well as in the preservation of mucogingival structures. However, the good results in the reconstruction of red and white esthetics have led to an increase in the patients' demands for a temporary restoration. Removable partial dentures, oftentimes the standard treatment, are considered to be unacceptable and also have many clinical drawbacks. Adhesive inserted single tooth, composite or Maryland bridges can significantly improve the patients' life quality and contribute to the perceived quality of therapy. Introduction For most people, the loss of one or more teeth has both a major emotional and at the same time a functional impact. This is all the more pronounced, the clearer the patient experiences the difference between before and after removal of the tooth. A sub-standard temporary restora- tion that is neither produced functionally nor esthetically has a sustained negative impact on day-to-day life quality. Patients frequently report a restriction in their social activity and a significant loss of weight. This inevitably leads to a nega- tive impact on compliance and the will- ingness to recommend the selected ther- apy and the attending dental practice. Modern implantology has a large number of sophisticated and clinically proven strategies at its disposal for the reconstruction of all anatomical structures. Patients take the prosthetic implant for granted as a perfect simulation of the natural tooth. But this is not necessarily the case. The outcome is more the consequence of individual, carefully matched therapy steps extending from the selection of the implant system, the surgical procedure of bone management, the exposure, through to the construction of the abutment and denture. In each of these treatment steps the dentist or implantologist chooses the best and safest procedure for his/her patients from a wide range of options. Nevertheless, even very experienced implantologists often neglect the phase of temporary restoration in the overall concept. The clasp prosthesis is usually used as the standard treatment following tooth extraction, sometimes even with hand-bent clasps. For the patient this is an unacceptable situation, which also has many clinical disadvantages. Due to both movement of the denture saddle overall, as well as localized deposition through to decubitus, the implantological bone bed is disturbed in its healing and maturation as a result of tissue stress. (Fig. 1) . The basic requirement for an optimal implantological overall outcome is, however, precisely stress-free tissue maturation, which extends from the conversion phase of the bone tissue after tooth extraction, including any augmentations, implantation, gingival shaping through to the prosthetic restoration. Depending on the starting situation, these biologically necessary rest phases easily add up to therapy times of over a year. If the patient is reliant on a sub-optimal temporary during this period, the entire course of therapy is perceived as inacceptable and stressful. Fig. 1: The implant is exposed with horizontal and torsional movement of the temporary Fig. 2: The very thinly finished vestibular clasp shell is made into a veneer. Fig. 3: The gray metal of the clasp shells is masked with metal opaquer.