Provisional Restorations Flashcards
What is the definition of a provisional?
A prosthesis designed to enhance esthetics, stabilization and/or function for a limited period of time after which it is to be replaced by a definitive prosthesis
What is a provisional used for?
Used to assist in determination of the therapeutic effectiveness of a specific treatment plan or the form and function of the planned definitive prosthesis
Many aspects of Fixed Prosthodontics require a __________ restoration to be fabricated indirectly in a dental lab.
definitive
What is the advantage of digital dentistry when it concerns provisionals?
With the advent of Digital Scanning and milling in the office, provisionals are then not needed as the patient leaves the office with a cemented definitive restoration.
What are the main functions of a provisional restoration?
- Prevent Sensitivity
- Prevent Drifting
- Allow tissues to heal
- Return function to dentition
- Esthetics
- Diagnostic evaluations
What are the requirements of a quality provisional?
- Pulpal protection
- Positional Stability
- Occlusal Function
- Ability to Clean
- Marginal Integrity
- Strength and Retention
- Esthetics and Phonetics
What do provisional restorations protect the prepared teeth from?
- Protect against plaque and saliva
- Protect against irritating and painful stimuli (temp changes, chemicals/fluids)
- Protect against abrasion or breakage of prepared tooth
What is important for positional stability of a provisional?
- Proximal contacts
- Occlusal Contacts
- Inter-abutment stability with a bridge
What is another term for a provisional?
temporary
A provisional will prevent _________ drifting of the prepared and/or adjacent teeth
lateral
When a patient comes back in for a crown seat appointment and tells you the temporary fell off a week and a half ago, anticipate…
adjustments which will need to be made to counter the tooth movements that likely occurred
A provisional with open contacts will allow…
food and debris to impact in between
What does a too open proximal contact on provisional with food/debris impaction lead to?
- leads to short term discomfort and pain
- leads to periodontal inflammation and possibility of too much bleeding to be able to seat the crown
Without appropriate contacts on your provisional, there is a good chance the teeth will…
shift collapsing the vertical between your preparation and opposing.
- results in extrusion
What can occur with the crown from the lab if extrusion occurs with the temporary?
- When trying to seat your definitive crown, the crown will be high resulting in more adjustment than desired.
- With too much adjustment, the material can be thinned and therefore weaker, or the anatomy is destroyed making your crown incapable of functioning appropriately in the occlusal scheme of the patient.
If the temporary is too ____, there will be pain, possible loss of the temporary, or a breakage of the temporary.
high
Time and care should be spent to ensure the temporary has what features?
contact, but appropriately shaped to allow function of temporary, while protecting the tooth
What should the occlusal contacts be on a provisional?
- Ideal centric occlusal contacts
- Lateral and Protrusive guidance where appropriate (anterior teeth)
- No contact in lateral or protrusive on posterior teeth
How should the provisional interact with the peridontium?
- Non-impinging margins
- Physiologic contours, emergence profiles, embrasures, and proximal contacts
- Smooth surface texture and finish
- All these lead to optimum periodontal health and predictable crown delivery
What does the margin of a provisional need to look like?
- Fit as close to the finish line of the tooth as possible
- Shape the contour to make is smooth, undetectable with an explorer with a smooth surface finish
- Seal the provisional at the margin to prevent pain, sensitivity or dislodgement.
The provisional emergency profile is…
flat or slightly concave NOT convexed or bulging
What does a rough margin of a provisional do?
- Leads to plaque accumulation and gingival inflammation
- Bleeding gums leads to very challenging impressions or crown seating.
Why does a temporary need adequate thickness?
Strength
- Temp must withstand forces without breaking or dislodgement
What are the characteristics of Bisacryl?
- Bisacryl material we use in this lab and in the clinic.
- Easy to use and easy to trim and polish
- Is a brittle material which can fracture if occlusal load is too strong and if material is too thin.
