PROVISIONAL RESTORATIONS

• Also known as temporary restoration

Requirements:
• Pulpal protection
• Positional stability
• Occlusal function
• Ease of cleaning
• Nonimpinging margins
• Strength and retention
• Esthetics

TYPES OF PROVISIONAL RESTORATIONS

• ZOE-inlay and FPD

1. Prefabricated versus custom restorations

• Prefabricated
✓ include stock aluminum cylinders (“tin cans”),
anatomical metal crown forms, clear celluloid
shells, and tooth-colored polycarbonate
crown forms
✓ used only for singletooth restorations
• Custom restorations
✓ can be fabricated of several different kinds of
resins by a variety of methods, direct or
indirect.

2. Direct versus indirect techniques

• Direct
✓ done on the actual prepared teeth in the
mouth
✓ eliminates the alginate impression and the
plaster cast
✓ technique sensitive.
✓ Resin and polymethyl methacrylate
• Indirect
✓ accomplished outside of the mouth on a cast
made of quick-set plaster.
✓ preferred over the direct technique for its
accuracy, pulp protection

RESINS FOR PROVISIONAL RESTORATIONS

1. Polymethyl methacrylate
✓ has been in use the longest.
2. Polyethyl methacrylate,
3. polyvinylethyl methacrylate,
4. bis-acryl composite resin, and
5. visible light–cured (VLC) urethane dimethacrylate

TECHNIQUES FOR CUSTOM PROVISIONAL RESTORATIONS

• Both elastomeric and alginate overimpressions Cementation
✓ have been used to shape the provisional
restoration.
• Overimpression
✓ made on the diagnostic cast or in the mouth
before the tooth preparation is begun.
• elastomeric impression
✓ provides excellent stability, although it is
more expensive than alginate

1. Overimpression-fabricated provisional crown

• use of an alginate overimpression remains a popular
technique because it is always readily available in the
dental operatory
2. Template-fabricated provisional fixed partial denture
• provisional restoration should also be in the form of a
fixed partial denture rather than individual crowns
Template technique
3. Template-fabricated VLC provisional restoration
• A transparent template is essential to the use of a VLC
resin (Triad, Dentsply) because the clear matrix allows
the light access to the resin to initiate polymerization
Technique
4. Shell-fabricated provisional restoration
• made from any of the acrylic resins, and then that
shell can be relined indirectly on a quick-set plaster
cast. It also can be relined directly in the mouth
• If too thick, the shell will not seat completely over the
prepared teeth and will need to be trimmed
internally.
Technique

5. Overimpression-fabricated bis-acryl composite crown

• used to fabricate a provisional restoration on a quick-
set plaster cast. Its polymerization produces very little
heat, and it has minimal toxic effect on soft tissues
and the pulp. It is well suited for use in a direct
technique
 TECHNIQUES FOR PREFABRICATED PROVISIONAL
RESTORATIONS
• Prefabricated polycarbonate or polymethyl
methacrylate crowns are easily adapted to produce
esthetic provisional crowns in an expeditious manner
on prepared single anterior teeth in most patients

1. Anterior polycarbonate crown

2. Provisional crown for an endodontically treated tooth
• It is often difficult to fabricate a provisional
restoration for a tooth that has been prepared for a
post and core because there is so little intact
supragingival tooth structure. This can be
accommodated for in the use of a standard
polycarbonate crown by placing a piece of paper clip
or other stiff wire into the canal and placing the resin-
filled crown over that

3. Preformed anatomical metal crown

• Emergency cases involving fractured molars are one
of the best indications for the use of preformed metal
crowns.
• y using the preformed anatomical metal crown, it is
possible to provide the patient with temporary
coverage to protect the fractured tooth and prevent
irritation of the tongue and mucosa
• The procedure consists of:
1. Minimal tooth preparation
2. Measurement and selection of crown
3. Trimming and adaptation of gingival
margin
4. Occlusal adjustment
5. Cementation