Temporary

Thomas

coverage

of anterior

teeth

M. Cooper,
of

B.S., D.D.S.*

University

Kentucky,

College of Dentistry, Lexington,

Ky.

fter completion of full crown preparations, the problem of satisfying esthetic requirements severely limits the materials that can be used to make temporary crowns for anterior teeth. This article will describe a technique in which a stainless steel anterior crown is used with a veneer of cold-curing acrylic resin to achieve the desired contour and appearance. A successful anterior temporary crown should : (1) protect the prepared tooth, (2) be esthetically acceptable, (3) maintain healthy gingival tissue, and (4) resist the masticatory forces tending to unseat it. In attempts to produce temporary crowns that are cosmetically acceptable, the gingival tissue is often abused. To maintain healthy gingivae after a tooth is prepared for an anterior full crown is difficult, but a few extra minutes spent at this time will insure firm, healthy gingivae when the restoration is completed. Celluloid crown forms, preformed acrylic resin crowns, and autopolymerizing (cold-curing) acrylic resin crowns are used for temporary coverage of anterior teeth, Although all of these are esthetically acceptable, considerable effort is necessary to produce an acrylic resin temporary crown that does not irritate the gingival tissue. Studies1 have shown that acrylic resin will shrink or expand seven times as much as tooth structure for every degree of temperature change. This produces a pumping action when hot and cold liquids are ingested and the resulting percolation causes marginal 1eakage.l The technique to be described will result in temporary restorations that are esthetically acceptable, possessadequate strength, and do not traumatize the gingival tissue.
TECHNIQUE

A

Immediately after placement of the gingival retraction cord around the tooth, a Rocky Mountaint stainless steel anterior crown of proper gingiual size is selected. It is neither necessary nor desirable for this crown to contact the adjacent teeth. The crown should be undersized, so that a veneer of 0.75 mm. to 1.0 mm. of acrylic *Assistant Professor. iRocky Mountain Corporation, Denver, Colo. 68

All gingival contouring is completed at this time. ‘/2 round bur (Fig. Proper gingival contour is established at this time with contouring scissors to pxoduce a metal margin 1. and the curvature of the free gingival margin is scribed on the labial surface of the crown with an explorer. 2 Fig. a body shade of . Fig. Fig. A body shade of tooth-colored resin is added to the stainless steel crown to mask the metal color. 4. 1. 3. 114 contouring plier is then used to produce a snug-fitting gingival margin (Fig.0 mm. The Rocky Mountain stainless steel crown is then removed from the tooth and the labial surfaces and proximal surfaces of the metal crown are stippled with a No. 2). 1). A stainless steel anterior crown is trimmed and the gingival part is contoured to fit the tooth. Incisal shade of tooth-colored resin is added to the anterior temporary duce the contour for the contact area after trial seating of the crown. crown to pro- resin can be added to it without producing an overcontoured temporary restoration. A stainless steel crown round bur before the acrylic is stippled on the labial resin veneer is added. and proximal surfaces with a one-hllf Fig. A No. subgingivally. 2.Volume 22 Number 1 Temporary conerage of anterior teeth 69 Fig. The level of the free gingival margin is scribed on the labial surface of the steel crown as a guide for trimming. No attempt is made to produce a final crown contour at this time. While the crown is held with a cotton plier on its cingulum. An inci~al shade of acrylic resin is then added to produce the desired crown form.

At this point. It may be used for temporary coverage during construction of a permanent crown or to protect a fractured anterior tooth for young patients. 6 Fig. The narrow *Claudius Ash Company. This will produce the desired crown contour. no attempt is made to produce a final contour of the crown. The contact areas are developed by slightly overbuilding them and seating the crown for a few seconds to mold this part of the acrylic resin (Fig. such as Sevriton” or Bon Fill. 5). An anterior temporary crown made from a stainless steel crown with a veneer of acrylic resin is not only esthetically satisfactory. tL. Y. incisal. Del. . Fig. and proximal surfaces of the crown (Fig. 5. Pros. Milford. The acrylic resin should be allowed to harden while the final impressions of the preparation are being made. 1969 Fig. Fig. Note that the acrylic resin veneer does not extend below the free gingival margin. The lingual view of the veneered anterior temporary crown shows the extension of the acrylic resin to the cingulum area. 6. The anterior temporary crown should be contoured and polished prior to cementation. Dent. After the final contour has been developed. July. N. Care should be taken to prevent any of the resin material from flowing below the previously scribed line which shows the free gingival margin. additional resin of an incisal shade is added to the resin already on the crown. one of the cold-curing tooth-colored acrylic resins. 3). 7. 5 Fig. D. Caulk Company.+ is applied to the labial.J. but it is also by far the strongest and most durable of all full-coverage anterior temporary restorations. the temporary crown is polished with a disk and seated with a temporary zinc oxide and eugenol cement (Fig. With the crown held by the cingulum again. Niagara Falls. 4).

rown using a metal resin. 7) . they should be made of a material other than acrylic resin. SUMMARY A technique crown veneered is presented for making a temporary with autopolymerizing (cold-curing) anterior c.Volume 22 1Number 1 TemporarJJ Coverage of anterior teeth 71 labial-lingual thickness of the crown at the in&al edge allows a band of the tooth resin to completely encircle the incisal 2/s of the crown. and it can be placed with a minimum of tooth reduction. layer of acrylic resin to achieve the desired masking of the metal without producing an overcontoured temporary crown. Podshadley and Harrison3 demonstrated a severe tissue-inflammatory response to unpolished acrylic resin. Due to the incisal-gingival convergence of Rocky Mountain anterior crowns. DISCUSSION Problems associated with acrylic resin temporary C~YXII~ZS. The temporary restora- . After several months. Acrylic resins wear away rapidly due to their low resistarce to abrasion. This type of temporarv crown is not easily dislodged. and it will become necessary to replace it. A temporary anterior Advantages crown that will be both esthetically acceptable and strong enough to resist the forces of mastication can be made from metal with a tooth shade acrylic resin veneer to improve the esthetics of the temporary restoration (Fig. Some reduction of the labial and lingual surface of the tooth is necessary to allow 1. Langeland and Langeland* studied the histologic response of the pulp to temporary crowns and observed that the autopolymerizing acrylic resins produced a severe inflammatory response when applied directly to the I:ooth. The metal-veneered temporary crown described here can be fabricated with less time and expense than an indirect autopolpmerizing resin anterior temporal y crown. and resists any attempt to displace it incisally. The entire veneer can be replaced without removing the metal crown. 6). it is necessary when removing it to cut the crown from the middle third of the lingual surface over the incisal surface to the middle third of the labial surface and spri-ng the crown slightly with a straight burnisher. Any excessive wear can cause the anteriot temporary acrylic resin crown to split and be dislodged by chewing forces. The acrylic resin temporary crowns cannot be worn more than a few dais. Recent studies? have shown that polishing cold-curing acrylic resins immediately after their curing process produces crazing in the material. The highly polished stainless steel margin suggested in this article is well tolerated by the gingival tissues and does not interfere with the normal healing process. the acrylic resin veneer is securely fastened to the metal.0 mm. of acrylic resin veneered stainless steel croz~ns. the acrylic resin veneer may discolor. Because of the excellent fit of this temporary crown. When the margins of a temporary crown must be placed subgingivally. This technique can also be used for young patients with fractured anterior teeth. and slight extrusion of the prepared teeth can occur. The temporary cement normally will come off with the crowu. and a minimal amount of time will be required to clean the prepared tooth. They urged the il*je of an indirect technique for fabricating acrylic resin temporary crowns. and this precludes a possible labial displacement of the resin material (Fig.

: Rat Connective Tissue Response to Pontic Materials. W. 40506 .: Relationship Between Crazing of Acrylic Resin Fillings and Times of Finishing and Polishing.. UNIVERSITY OF KENTUCKY MEDICAL CENTER DEPARTMENT OF RESTORATIVE DENTISTRY LEXINGTON. Langeland. Fusayama. 1966. Impression. PROS. J. DENT. KY. 1966. J.: The Science of Dental Materials. R. W. M. H. 16: 1 lObll8. 4. 15: 129-143. Temporary Crown Fixation. Saunders Company. K. 16: 140-144. Philadelphia. J. References irritation than 1. and Permanent Cementation. July. W. T. PROS. and Phillips. and Langeland L. pp. 229-230.. DENT. J. and Hosoda. Skinner. Pros.: Pulp Reactions to Crown Preparation. E. 1965.. 2.. PROS. A. all-acrylic resin temporary crowns. Podshadley.72 Cooper and produces less gingival J. 3. 1967. Dent. 1969 tion is strong and esthetically acceptable. B.. Miyazawa. and Harrison. DENT.

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