Provisional extra coronal restorations Flashcards

1
Q

What is a provisional extra coronal restoration?

A

A restoration provided between tooth preparation and fit of an indirect extra coronal restoration

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2
Q

Provisional restoration function

A

tooth preparation
- compromises aesthetics in smile lines
- degrades of tooth function (occlusion reduction and destabilised occlusion)

occlusal and inter proximal reduction:
- may render a tooth sensitive due to exposed dentine
- compromised coronal seal o RCT’d tooth

provisionals restore these characteristics

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3
Q

A provisional restoration should…

A

have good marginal fit
be well contoured
- no overhangs
be cleanable and maintainable by patient
establish and/or maintain dental aesthetics, mimicking either
- original tooth
OR
- definitive restoration
prevent sensitivity
allow optimum home care
prevent micro leakage
- preserve tooth vitality

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4
Q

consequences of a poor fitted and poorly contoured provisional restoration

A

patient unable to clean
- caries
- gingival inflammation
- poor moisture control
- gingival overgrowth

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5
Q

Functional characteristics of a provisional

A

confirm tooth prep is adequate
occlusal stability
- no changes in OVD unless desired
- prevent drifting or tilting of prepared teeth
preserve or improve function
- mastication
- speech

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6
Q

desirable properties of provisional materials

A

non irritant
low temperature rise on setting
dimensionally stable
adequate working and setting times
adequate strength and wear resistance
good aesthetics

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7
Q

types of provisional restorations

A

custom formed
preformed

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8
Q

features of a custom formed provisional restoration

A
  • bespoke to individual situations
  • preferable
  • can be technically demanding
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9
Q

features of a preformed provisional restoration

A
  • standard shape and sizes
  • adjusted to fit chair side
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10
Q

material used for custom resin provisional crowns

A

chemically cured bis-acrylic composite resin

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11
Q

outline method for impression taking for custom resin provisional crowns

A

sectional impression
prep tooth for chosen restoration
syringe bis-acrylic composition resin material onto mixing pad
- ensure it is mixed
- monitor setting
syringe material into sectional impression
relocate impression into mouth
- ensure full seated
- should click over bulbosity of remaining teeth
remove before complete polymerisation
remove completely
- may stay on tooth - gently ease off with instrument beneath contact points
remove flash and ledges
- high speed and/or polishing discs

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12
Q

outline steps taken for checking provisional restoration

A

confirm tooth preparation
- Svenson gause
check marginal fit and occlusion in situ
check aesthetics
cement provisional restoartion
- temporary luting cement
- trim away excess

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13
Q

how to establish occlusion and aesthetics its a provisional restoration

A

loss of original tooth form e.g. wear cases:
- re-establish tooth shape
- trial occlusion and aesthetics using provisional restoration

guidance (anterior/incisal)
- produce on crowns:
diagnostic wax up
articulated study models
faccebow registration

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14
Q

types of preformed provisional crowns

A

tooth coloured
- polycarbonate
- clear plastic crown forms - filled with composite

metal
- aluminium
- stainless steel

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15
Q

preformed provisional crown - problems

A

unlikely to fit accurately
- cervically
- occlusally
- interdentally
large bank of crowns needed
- to accommodate variation between patients
- costly

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16
Q

When are preformed provisional crowns useful?

A

when no impression was taken prior to tooth preparation or damage
- e.g. trauma cases

17
Q

outline the step by step method for fitting a preformed provisional crown

A

select shell slightly larger than preparation
term back until
- correct preparation dimension
- seats fully over tooth preparation
- not bedding into gingivae
fit shell
- pro temp
seat over tooth
allow polymerisation
remove
check fit
trim/tidy if necessary
cement
- temporary luting cement
cut off tag

18
Q

When could composite be used as a provisional?

A

in veneer cases

19
Q

patient advice following provisional restoration

A

maintain goof OH
- brush 2-3x daily
- 1-2x daily interdental cleaning
- caution with floss - may pull out provisional

poor OH =
gingival inflammation
increased
- GCF
- Bleeding
- poor moisture control for definitive impressions
- inadequate cement lute placement