Provisional resorations Flashcards
What does a poor provisional lead to
Patient unable to clean
-Caries
-Gingival inflammation
What are the desirable characteristics of a provisional crown
Non-irritant
Low temperature rise during setting
Dimensionally stabile
Adequate working time
Adequate setting time
Adequate strength and wear resistance
Good aesthetics
What are the types of provisional restorations
Custom formed
-“Bespoke” to individual situations
-Preferable
-Can be technically demanding
Preformed
-Standard shapes and sizes
-Adjust to fit chairside
What are custom formed provisionals made out of
Chemically cured bis-acrylic composite resin
Examples:
Protemp Plus (3M ESPE)
Integrity Temp-Grip (Dentsply)
When do you make the impression for custom
Make before impressions for definitive restoration are taken
-Helps check that tooth prep is satisfactory
What is the iwanson gauge
Used for measuring thickness of customisible provisionals
Is designed to determine the correct height of dental restorations, such as crowns or bridges, in relation to the patient’s natural teeth
What is the method for a provisional crown
1) Sectional impression (addition cured silicone putty)
2) Tooth prep
3) Syringe bis-acrylic composite resin material onto bracket table or mixing pad
-Ensure its mixed and monitr its setting
4) Syringe material into sectional impression of tooth that has been prepared
5) Relocate impression in the mouth
6) Remove before complete polymerisation
7) Remove completely
8) Remove flash and ledges
9) Confirm tooth prep
10) Check marginal fit and occ.
11) Check aesthetics
12) Cement (Temporary luting cement E.g. TempBond NE)
What else can provisionals be used for
Used for restablishing lost tooth form eg. from tooth wear
Establishing gingival contours used to achieve satisfactory emergence profile for definitive restoration eg. implants
What type of preformed provisional crowns are there
Tooth coloured
-Polycarbonate (Directa)
-Clear-plastic crown forms filled with composite
Metal
-Aluminium
-Stainless steel
Different shapes/morphology and sizes
What are the Adv and DisAdv of preformed provisional crowns
Adv
-Useful for situations where no impression taken prior to tooth preparation or damage
DisAdv:
Unlikely to fit accurately
-Cervically
-Occlusally
-Interdentally
Large bank of crowns needed
-Accommodate variation between patients
-Costly
What is the method for performed provisional crowns
Select shell slightly larger than preparation
Trim back until
-Correct preparation dimension
-Seats fully over tooth preparation
-Not bedding into gingivae
-Pink stone in straight handpiece
Fill shell
-Trim or Protemp
Seat over tooth
Allow polymerisation
Remove
Check fit
Trim/Tidy if necessary
Cement
-Temporary luting cement (e.g.Tempbond)
Cut off tag
ethod for clear plastic prov. retoration
Select and trim until fit
Pierce hole at cusp tip/canine tip/incisal angle
-Air escapes
-No bubbles
Fill with bis-acrylic composite resin
Seat over tooth
Allow setting
Remove from tooth
Remove plastic crown form
Check margins and occlusion
Adjust if necessary
Cement with temporary cement
Prov. restoration must
Establish and/or maintain dental aesthetics, mimicking either
-Original tooth
-Definitive restoration
Prevent sensitivity
Allow “optimum home care”
Prevent microleakage/bacterial leakage
