Provisional restoration in Prosthodontics

1. PROVISIONAL RESTORATION
OR
TEMPORIZATION
Under the guidance of:
Dept. Of Prosthodontics and Crown and Bridge
NORTH BENGAL DENTAL COLLEGE AND HOSPITAL

2. • DEFINITION:
A fixed or removal prosthesis designed to
enhance esthetics stabilization and function for a
limited period of time after which it is to be
replaced by definitive prosthesis.( GPT- 8 )
• SYNNONYMS:
Temporization, interim prosthesis, provisional
prosthesis.

3. Why provisional restoration needed???
• Provisional restoration is given for a period of
time until a permanent arrangement can be
made.
• To protect the prepared tooth and kept patient
comfortable.
• By successful treatment with provisional
restoration dentist can get the patient confidence
which is an influencing factor for success in the
final restoration.

4. IDEAL REQUIREMENTS OF PROVISIONAL
RESTORATION
Three basic requirements :
• Biologic requirements
 Pulp protection
 Periodontal health
 Positional stability
 Prevention of fracture
• Mechanical requirements
 Function
 Loss of retention
 Removal of reuse
• Esthetic requirements
 Colour compatibility
 Translucency
 Colour stability

5. BIOLOGIC REQUIRMENTS
 PULP PROTECTION:
 During tooth preparation the dentinal
tubules are exposed.
 Thus provisional restoration should
protect the prepared tooth from
oral environment, thereby preventing
sensitivity and irritation to pulp.
 PERIODONTAL HEALTH:
It should have good marginal fit,proper contour
and smooth surface to prevent
accumulation of plaque,facilitate easy plaque
removal and maintain periodontal
health.

6. BIOLOGIC REQUIRMENTS
 POSITIONAL STABILITY:
It should provide a comfortable, stable, and functional occlusal relationship by
maintaining interarch and intra-arch stability thereby preventing tooth migration ,
supraeruption.
 PREVENTION OF FRACTURE:
It should protect the prepared tooth surface
from fracture which is commonly seen
in partial coverage restoration, in which margin
of preparation is close to the occlusal surface
of tooth and could be damaged
during chewing.

7. MECHANICAL REQUIREMENT
 FUNCTIONAL:
It should possess good compressive and flexural strength. The strength of material
used for fabricating provisional restoration is always much lower than that of the
definitive restoration material.
The greatest stresses in a provisional restoration occur during chewing.
 LOSS OF RETENTION:
It should have close adaptation to the prepared tooth surface to prevent displacement
and recementation, which will increase patient visits.

8. MECHANICAL REQUIREMENT
 REMOVAL OF REUSE:
Provisional restoration may need to be removed and recemented often.
If they are well fabricated with adequate thickness and cemented with weak cement
Can be removed without breakage.
ESTHETIC REQUIREMENT
It should match the shape, size, colour, and texture of the restored tooth especially in
the anterior region.
Colour stability is also important if the provisional are to function for a prolonged
period.
It also serves as a guide to achieve aesthetics to the final restoration.

9. CLASSIFICATION
 Provisional restorations are classified on the following basis:
 According to method of fabrication:
 Preformed
 Custom made
 According to material used:
 Resin :
 Preformed (Polycarbonate, Cellulose acetate)
 Custom made (Acrylics, Bis-acryl composites)
 Metals:
 Preformed (Aluminium, Tin silver, Nickel chromium)
 Custom made (Cast metal alloy)
 According to duration of use:
 Short term.
 Long term.
 According to technique of fabrication:
 Direct technique.
 Indirect technique.

10. PROVISIONAL RESTORATION MATERIAL
 IDEAL REQUIRMENTS OF PROVISIONAL RETORATIVE MATERIAL:
 Adequate strength and wear resistance.
 Biocompatible.
 Good dimentional stability.
 Easy to contour and polish.
 Odourless and non-irritating.
 Chemically compatible with luting cement.
 Esthetically acceptable.
 Adequate working and setting time.
 Easy to repair.

11. PROVISIONAL RESTORATION MATERIAL
 MATERIALS USED:
 Resin :
 Acrylics
 Polymethyl methacrylate
 Ploy-R’ methacrylate
 Bis- acryl composites
 Chemically activated
 Light activated
 Dual activated
 Metals :
 Cast metal alloy
Advantage & disadvantage of ploy-r methacrylate
Advantage & disadvantage of poly methyl methacrylate
Advantage & disadvantage of bis-acryl composites

12. PRE-FORMED PROVISIONAL RESTORATION
Depending on the Types of Material Used:
 Resin based provisional restoration
 Cellulose acetate
 Polycarbonate
 Poly methyl methacrylate
 Poly-R methacrylate
 Microfilled composite
 Urethane dimethacrylate
 Metal provisional restoration
 Aluminium
 Nickel- Chromium
 Tin- Silver

13. RESIN:
Polycarbonate crowns:
They combine microglass fibers with polycarbonate plastic material.
It is used as a matrix material around a prepared tooth .
It possesses high impact strength, abrasion resistance,
and good bond with meth acrylate resin.
Best esthetic among all preformed crowns.
Available in shape of incisor, canine, and premolars
in varying size
Cellulose acetate:
It is thin, soft, transparent scaffold material.
It is available in all tooth shape and different sizes.
It does not bond to the relining resin.
An approximately size of this crown is selected from
a mould guide and filled with autopolymerizing resin
of appropriate shade.
This is inserted over the lubricated prepared tooth.

14. METALS:
 Aluminium:
These are generally limited to posteriors for esthetics reasons.
Available as simple shell.
They provide good adaptation due to softness and
difficulty of the material, but can also promote rapid
wear resulting in perforation.
They may be relined with resin to obtain better fit and rigidity
and then luted to prepared tooth.
 Nickel- Chromium:
Indicated for use in children with damaged primary teeth.
They need not to reline with resin.
They are trimmed, contoured, and adapted to the tooth.
Strong cements are used for luting.

15. TECHNIQUES OF FABRICATION
DIRECT
TECHNIQUE
INDIRECT
TECHNIQUE
DIRECT-INDIRECT
TECHNIQUE

16. DIRECT TECHNIQUE
APPLICATION OF SEPARATING
MEDIA ON PREPARED TOOTH
PUTTY INDEX WITH RPD AND
TRIMMED FLANGE
REMOVABLE PARTIAL DENTURE
IN PLACE
PRE OPERATIVE PICTURE
RESIN MIXED AND POURED IN THE
INDEX
MAKING PUTTY INDEX WITH THE
RPD
ALLOWED TO SET RESIN WITH RPD
IN THE INDEX
INDEX RESEATED IN THE MOUTH TRIMMED PROVISIONAL
PROSTHESIS

17. INDIRECT TECHNIQUE
DIAGNOSTIC CAST WITH MISSING
MANDIBULAR INCISORS
ARTIFICIAL TEETH ARRANGED CAST WITH ARTIFICIAL TEETH
VACUUM FORMED
CAST FOLLOWING TOOTH
PREPARATION
TOOTH PREPARATION DONETEMPLATE PLACED ON CAST TO
CHECK FIT
TEMPLATE SEATED ON CAST
FILLED WITH THE PROVISIONAL
RESTORATIVE MATERIAL IN THE
AREA OF RESTORATION
TEMPLATE REMOVEDFROM
CAST AFTER POLYMERIZATION
PROVISIONAL RESTORATION
TRIMMED AND FITTED ON CAST

18. DIRECT-INDIRECT TECHNIQUE
FINAL DIRECT INDIRECT PROVISIONAL
RESTORATION
INDIRECT PROVISIONAL RESTORATION
TRIMMED AND FIT ON CAST
ABUTMENT TEETH PREPARED IN
PATIENT MOUTH
POLYMERIZING ACRYLIC RESIN
POURED INTO PUTTY INDEXPREPARATION COMPLETE IN MODELTOOTHPREPARED MINIMALLY IN
THE MODEL
PUTTY INDEX
FABRICATED
ON THE DIAGNOSTIC CAST
,EDENTULOUS AREAS ARE
RESTORED AND WAX
CORRECTION ARE DONE
STABILIZING RESTORATION IN PATIENT
MOUTH
ACRYLIC RESIN ADDED TO RETAINER IN
THE PROVISIONAL RESTORATION
PUTTY INDEX SECURED ON THE CAST
BY RUBBER BAND

19. CEMENTATION OF PROVISIONAL RESTORATION
 IDEAL PROPERTIES OF CEMENT:
 Ability to seal against leakage of oral fluid.
 Strength consist with intentional removal.
 Low solubility.
 Chemical compatibility with provisional polymer.
 Ease of eliminating excess.
 Adequate working time and short setting time.
 CEMENTS USED:
 Zinc oxide eugenol.
 Reinforced zinc oxide eugenol.
 Non- eugenol cements.
 Zinc phosphate, Zinc polycarboxylate, and Glass ionomer cements are not used
because their comparatively high strength makes intentional removal difficult.

20. LIMITATIONS OF PROVISIONAL RESTORATION
 Lack of adequate strength—fracture of provisional is possible in
long span FPDs, patient with bruxism and reduced interocclusal
clearence.
 Inadequate marginal adaptation.
 Poor aesthetic in long term provisional restoration.
 Plaque accumulation due to poor surface characteristic.
 Compromised bonding characteristics.
 Mild to moderate tissue irritation

21. References:
Contemporary fixed prosthodontics-
Rosenstiel, Land, Pujimoto
Textbook of prosthodontics-
V Rangarajan