1. Provisional Restorations
Dr. Arwa H.AL-Musa
211 RDS

2. Definition
A dental prosthesis worn following the tooth preparation for a various periods of time, which maintains esthetics, provides articulating surfaces & protects hard & soft tissues prior the delivery of the permanent dental prosthesis (temporary, interim)

3. Requirements

4. 1- Protect the remaining tooth
structure from chemical, thermal &
biological insult.

5. 2- Pulpal protection:
a- Thermal insulation
b- Well adapted margins to
prevent leakage of saliva

6. 3- provide for esthetics, phonetics
and masticatory function

7. 4- Maintain the health of the
periodontium, should have no
overhangs or impinging margins

8. 5- Diagnosis and patient evaluation.

10. Types of Provisional Restorations

11. 1- Zinc oxide eugenol (IRM).
2- Prefabricated provisional
restorations.
3- Custom made provisional

12. Zinc oxide Eugenol

13. Zinc oxide eugenol (IRM) :
Polymer-reinforced zinc oxide eugenol interim restorative material used for small intracoronal preparations e.g. inlays

14. Disadvantages:
a- doesn’t protect the remaining
tooth structure
b- can only be used as an
intracoronal restoration

15. Prefabricated Provisional
Restorations

16. Definition:
ready-made restoration that
needs minimal adjustment
e.g polycarbonate crowns,
metal crowns

17. Polycarbonate Crowns

18. Tooth colored, supplied in incisor, canine and premolar shapes

19. mimic the natural tooth color Available only in one shade
Adv.
mimic the natural tooth color
Dis.
Available only in one shade

20. Prefabricated Metal Crowns

21. Suitable for posterior teeth
Needs some modifications for
proper adaptation

22. Steps of fabrication

23. 1- after tooth preparation, select the proper
crown size from the mold

25. 2- Adjustment: A- polycarbonate crown:
adjust the length of the crown by trimming the excess gingival part using carborundum stone or acrylic bur

26. 2- Adjustment: A- Metal crown:
length is adjusted by removing gingival excess by scissors, then smoothened and contoured using plires.

27. 3- apply separating medium on the prepared tooth ( petroleum jelly)
4- mix autopolymerizing acrylic resin in a dappen dish

28. 5- Fill the crown with acrylic resin then seat it correctly on the tooth and remove the excess resin around the margins.

29. 6- check the occlusion using articulating paper

30. 7- remove the high spots then finish it and polish it using white stone burs and rubber points.

31. 8- cement it using temporary cement.

33. Custom Made Provisional

34. Made to fit specifically the patient’s prepared tooth

35. Techniques for Fabricating Custom Made Provisional

36. 1- Direct
2- indirect

37. Direct
Made directly inside the patient’s mouth

38. Indirect:
Made outside the patient’s mouth

39. Custom made provisional
Steps for fabricating
Custom made provisional

40. 1- Direct technique

41. 1- Take a preoperative impression ( before
the tooth preparation).

42. 2- After tooth preparation, apply a light
film of petroleum jelly ( separating
medium).

43. 3- Mix the self-cure acrylic resin in a
dappen dish.

44. 4- Fill the impression at the area of the
prepared tooth with acrylic resin.

45. 5- Place the impression on the prepared
tooth correctly.

46. 6- Take it in and out until the material
sets.

47. 7- Remove the provisional rest.

48. 8- Then finish it and polish it.

49. 9- Check the occlusion then cement it
using temporary cement e.g. temp bond
cement.

50. Wake Up!!

51. 1- Indirect technique

52. 1- Take a preoperative impression.

53. 2- After tooth preparation take a postoperative
impression and pour it to get a
postoperative cast.

54. 3- Apply a separating medium on the cast
then mix some acrylic resin in a dappen
dish.

55. 4- Fill the preoperative impression at the
area of the prepared tooth with acrylic
resin.

56. 5- Seat the postoperative cast into the
preoperative impression.

57. 6- After the resin has set remove the
provisional and finish it an polish it.

58. 7- After the resin has set remove the
provisional and finish it an polish it.

59. 8- Try it in the patient mouth and check
the occlusion

60. 9- Cement it using temporary cement
material.

61. It’s almost over

62. Direct Faster Fewer steps Slightly inferior in marginal fit
Adv.
Faster
Fewer steps
Dis.
Slightly inferior in marginal fit
Might lock in the undercuts of the prepared tooth
Thermal &chemical insult to the tooth

63. Indirect Takes more time Has more steps Better marginal fit
Adv.
Better marginal fit
Avoids the possibility of locking on the tooth
No thermal or chemical insult to the tooth or soft tissue
Dis.
Takes more time
Has more steps

64. Materials Used for custom made provisional restorations

65. 1- polymethyl methacrylate
Adv.
High strength
color stability
wear resistance
Dis.
Tissue damage from the monomer & exothermic heat reaction
Polymerization shrinkage

66. 2- polyethyl methacrylate
Adv.
Less exothermic heat reaction
Less polymerization shrinkage
Dis.
Less color stability
Less wear resistance

67. 3- Filled Resins: Most esthetic Accurate fit Brittle
Adv.
Most esthetic
Accurate fit
Dis.
Brittle
subject to bulk fracture