Provisional restorations finalised /certified fixed orthodontic courses by Indian dental academy

PROVISIONAL

RESTORATIONS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

1

A

fixed or removable
prostheses designed to
enhance esthetics,
stabilization and /or function
for a limited period of time,
after which it is to be replaced
by a definitive restoration.

2

FUNCTIONS
B OGICAL
IOL

M CH
E ANICAL

E HT
ST E IC


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BIOLOGICAL
Pulpal

protection.
Maintain periodontal health.
Provide occlusal
compatibility.
Maintain tooth position.
Protect against fracture.

4

Pulpal protection
The restoration must

be fabricated of a
material that will
prevent.
•Conduction of
extreme temperatures.
•Microbiological
infection.
•Chemical, mechanical
injuries.


5

Periodontal Health

•Extent of margins.
•Contour.

6

Occlusal compatibility


Proper
occlusal and
proximal
contacts
promote
patient
comfort and
maintain
tooth
position.
7

Maintain tooth position

Prevent migration and extrusion of
the prepared abutment.

8

Protect against fracture


9

MECHANICAL
Resist functional

loads.
Resist removal of forces.
Maintain interabutment
alignment.

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ESTHETIC
Easily contourable.

Color compatibility.
 Translucency.
 Color stability.



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Types of provisional restorations


Prefabricated

Metal
Anatomic metal crown forms
Tin – silver
Nickel chromium
Stock aluminum cylinders

Resin
Cellulose acetate
Tooth colored poly carbonate
crown forms



Custom made


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Materials
IDEAL PROPERTIES
1.
2.
3.
4.
5.
6.
7.
8.

Convenient handling
Bio compatibility
Dimensional stability
Ease of contouring and polishing
Adequate strength and abrasion
resistance
Good appearance
Good patient acceptance
Ease of adding or repairing

13

MATERIALS
AVAILABLE
Polymethyl methacrylate.
Polyethyl

methacrylate .
Polyvinyl ethyl methyl methacrylate .
Bis acryl composite.
VLC urethane dimethacrylate.
Aluminum.
Tin-silver.
NiCr.

14

TECHNIQUES

DIRECT

Provisional restoration is done
on the actual prepared teeth in the
mouth.
INDIRECT
Provisional restoration is
fabricated outside the mouth on the
cast made of quick setting plaster.

15

DIRECT vs INDIRECT
TECHNIQUES
Direct
1. Intermediate
steps of indirect
technique are
eliminated.
2. Convenient when
assistant training
and laboratory
facilities are
inadequate.

Indirect
1. No contact of free monomer
with the prepared tooth or
gingiva, causing damage to
the tissue.
2. Better marginal fit.
3. Less chair side work.


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TECNNIQUE FOR PRE FABRICATED
PROVISIONAL RESTORATION

POLY CARBONATE
CROWNS
DIR CT T CH
E
E NIQUE

Select a appropriate sized
or slightly larger crown
form , and trim the shell to
the appropriate size. Try
the shell in the prepared
mouth.
2. Apply a uniformly thin
coat of petroleum jelly on
the prepared tooth and
surrounding tissues.
1.


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3. Mix the auto-

polymerizing resin and fill
the shell ,place the shell
over the tooth and align it.
4. Eliminate any marginal
excess.
5. When the
polymerization reaches
rubbery stage remove the
crown and place it in
warm water.

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6. After the resin had set the margins are

marked flash is eliminated ,axial surfaces are
shaped , occlusion is checked and adjusted
7. Finally, polish and cement the restoration


19

INDIRECT PROCEDURE
When the preparation has been
completed make an impression of the
prepared mouth, and pour the cast with
quick setting plaster.
2. Select a appropriate sized or slightly
larger crown form , and trim the shell to
the appropriate size.
3. Paint the cast of the prepared tooth and
the surrounding area with the separating
media.
1.


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4. Fill the crown with resin, and seat it on
the plaster cast firmly. place it in a
bowl of warm water to accelerate
polymerization.
5. When the resin is set, remove the
provisional crown from the cast, trim
the excess , if necessary recontour the
axial surfaces ,check the occlusion
and adjust it.
6. Finally, polish and cement the
restoration.

21

ALUMINUM CROWN FORMS
They are useful in restoring a single posterior

tooth.
PROCEDURE
1. The mesiodistal width of the tooth is measured
and appropriate size of the crown is selected.
2. The occluso-cervical height is measured and the
crown is trimmed so that it extends 1mm apical to
the gingival margin.
3. Crown is placed on the prepared tooth and the
margins are trimmed wherever the gingiva
blanches.
4. Instruct the patient to close with a moderate force.

22

5. Apply petrolatum jelly to the pre pared tooth
surface and the adjacent tissues. Mix the auto
polymerizing resin and fill the crown, place the
crown over the tooth.
6. When the polymerization reaches rubbery stage,
remove the crown and place it in warm water.
7. After the resin had set the margins are marked,
flash is eliminated, axial surfaces are shaped ,
occlusion is checked and adjusted.
8. Acrylic is added in the deficient parts if any.
9. Finally, polish and cement the restoration .

23

Techniques for custom provisional
restorations
Over impression fabricated provisional
restoration
An over impression is made on the
diagnostic cast or in the mouth before the
tooth preparation had begun.
Alginate and elastomeric materials can
be used for over impressions.
An over impression frequently is made
from the patients mouth.

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If

tooth to be restored
has any obvious
defects the over
impression can be
made from the
diagnostic cast.
Utility wax is placed
on the defect.
Over impression is
made from the
diagnostic cast.


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When the tooth preparation

is completed impression is
made.
Quick setting plaster is
poured into the impression..
After the plaster sets the cast
is retrieved and trimmed .
The trimmed cast should
have at least one tooth on
either side of the prepared
tooth.
Try the plaster cast into the
over-impression.

26

Paint the surface of

the

prepared tooth and
surrounding area on the
cast with the separating
media.
Mix the auto
polymerizing resin and
place it in the over
impression.
Seat the cast in the
impression. Hold it
firmly with a rubber
band

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•After the resin had
set the margins are
marked, flash is
eliminated ,axial
surfaces are shaped ,
occlusion is checked
and adjusted
•Finally, polish and
cement the
restoration


28

Over impression fabricated
provisional restorations


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30

TEMPLATE FABRICATED


31


32


33

1.
2.
3.
4.
5.
6.
7.
8.
9.

LIMITATIONS OF PROVISIONAL
RESTORATIONS
Lack of inherent strength.
Poor marginal adaptation.
Color instability.
Poor wear properties.
Odor emission.
Inadequate bonding characteristics.
Poor tissue response to irritation.
Arduous cement removal.
Time expenditure for fabrication can be
prohibitive.

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CEMENTATION

IDEAL PRORERTIES OF LUTING AGENT
Ability to seal against the oral fluids.
Strength consistent with intentional removal.
Low solubility.
Blandness or obtundency.
Chemical compatibility with the polymer.
Easy to dispense and mix.
Ease of eliminating excess.
Adequate working time and short setting time.
Compatibility with definitive luting agent.

35

TECNNIQUE FOR PRE FABRICAT
POLY CARBONATE CROWNS

Seat crown on
preparation. Mark
gingival contour
using a pencil
remove the crown
and trim 1mm below
the line using crown
scissors , bur or
stone


36


Cervical
margins
can be
crimped, if
needed
using
crimping
pliers.
Reseat and
check fit.
37

Line crown
with
provisional
acrylic or
resin
material to
enhance fit
and extend
wear

38


Remove
from the
mouth and
trim to finish
line using a
carbide bur .
Smooth and
polish as
required,
using discs
and rubber
wheel
39


Mix
cement
and fill
crown,
assuring
voids are
not
present
in the
cement.

40


Seat crown
and allow
cement to
set. Remove
the excess
cement with
scaler or
explorer.
Floss
interproximal
areas.
41

Temporary metal crowns
Crown selection
Determine
the mesiodistal width.
Select
appropriate
crown.

42

Trial fit
For chamfer preparation
Press
gently to
stretch
crown cervix
over finish
line of
preparation

43

For shoulder preparation
Slightly flare the
cervix of
crown on the
stretch block.
Do not over
expand.

44

Seat
expanded
crown on
prepared
shoulder


45

Crown preparation
If gingival
blanching
occurs during
trial fit, trim
crown using
crown
scissors

46

Reset in mouth
and have
patient
establish
occlusion


47

Use a sharp
explorer to mark
the marginal
contour. Trim
crown back to the
line using a
crown scissors.
Smooth and
polish if desired
using discs and
rubber wheel.
and rubber wheel


48

Mix cement
and fill crown
assuring
voids are not
present in
the cement.


49

Crown cementation
Seat the
crown and
have the
patient bit
into
occlusion.

50

Burnish the
cervical
margin to the
preparation
before the
cement sets
completely


51

Remove
excess
cement with
scaler or
explorer.
Floss
interproximal
areas

52

Thank you
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53

Provisional restorations finalised /certified fixed orthodontic courses by Indian dental academy

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