Restorative - Provisional extra-coronal

Question 1

What are the four clinical stages for indirect restorations?

Answer 1

Preparation
Temporisation
Impression and registration
Cementation

Question 2

When are provisional restorations provided?

Answer 2

Between the tooth prep stage and then fit on indirect restoration.

Question 3

What would happen if a provisional wasn’t placed after tooth preparation?

Answer 3

Aesthetics would be compromised
The coronal seal of the RCT’d tooth may be exposed
Degrade tooth function
The tooth could have exposed dentine and be sensitive

Question 4

By placing a provisional it should restore and have what?

Answer 4

Restore function and aesthetics
SHould be self-cleansing and easily maintainable for the patient.
Have no overhangs
Good marginal fit

Question 5

Poorly fitted provisionals can lead to what?

Answer 5

Poor margins and self-cleansing action.
Which leads to caries, gingival inflammation and enlargement, affecting the definitive impression and therefore giving an inaccurate record of the margins

Question 6

Overall a provisional must be what? give 6 examples.

Answer 6

Restore function and aesthetics
Prevent microleakage
Preserve vitality
Maintain occlusal stability
Allow for optimum 'home care'
Prevent sensitivity of exposed dentine

Question 7

What are the 7 desirable characteristics of a provisional material?

Answer 7

Non-irritant 
Low temperature rise during setting to prevent expansion
DImensionally stable 
Adequate working time 
Adequate setting time 
Adequate strength and wear resistance 
Aesthetic

Question 8

Two types of provisionals?

Answer 8

Pre-formed

Custom formed

Question 9

Example of a custom formed provisional material?

Answer 9

ProTemp Plus

Chemically cured bis-acrylic composite resin

Question 10

What instrument is used to detect undercuts

Answer 10

te Svensen guage

Question 11

What are the sectional impression material options?

Answer 11

Silicone putty (president) - easily disinfected and reusable. Doesn't tear)
Alginate - Cannot be reused but is cheap

Question 12

Explain the 10 steps in the method of placement of a provisional.

Answer 12

1) Take a sectional impression
2) Prepare the tooth for the chosen material
3) Syringe proTemp into the sectional for proposed tooth
4) Place the impression in the target area of the mouth and seat down properly.
5) Remove before complete polymerisation
6) Remove flash and edge
7) Check and confirm tooth prep
8) Check margins and occlusion
9) Check aesthetics
10) Cement provisional into place using TempBond.

Question 13

How do you remove the provisional restoration from the mouth after initial placement?

Answer 13

Using instruments gently ease off beneath the contact points

Question 14

How do you remove flash and edge?

Answer 14

WIth high speed or polishing discs

Question 15

What are you checking for when checking the tooth prep?

Answer 15

Undercuts (svensen guage)

Check appropriate thickness

Question 16

What must you do after cementation to allow for “at home cleaning”?

Answer 16

Remove any excess cement from the mouth, especially between the contacts. Do this with floss interdentally.