Below is a classic 4 week post surgical reline. After a core and provisional is completed and periodontal corrective procedures are finished. A 4 week initial healing period is required. During this initial 4 week healing period, no modification is made to EITHER the teeth or provisionals. 

At 4 weeks, NO CHANGE OR PREP is made to the teeth. But the provisional is now relined 1mm coronal to the healing tissue. No tooth marination. Just a razor sharp provisional margin that dies into the glassy smooth tooth that has Zero margin prep. 

This approach allows for the coronal migration and maturation of the attachment. 

1. If you prepare a finish line on the tooth at four weeks, you have now committed a new finish line margin. This is a mistake because the attachment has not matured coronal yet.

2. If you place the provisional margin too close to the tissue, whether or not the tooth has been re-marginated. You run the risk of impingement on a coronally migrating attachment. This will produce chronic inflammation indefinitely.

Therefore, realigning the professional 1 mm shy of the tissue allows for continued healing and maturation of the attachment. Only after an additional 16 weeks, should you consider committing a finish line and preparation of the tooth.

Below is the initial placement of the provisional prior to surgery. Below that is the four week reline.

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Daniel Melker

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