A provisional removable partial denture for use during construction of an anterior splint bar prosthesis.

A technique for constructing a provisional removable partial denture before and during construction of an anterior splint bar prosthesis is described. The provisional prosthesis is easily adapted to fit the splint bar prosthesis after it is cemented in place. The technique assures that the patient will enjoy the benefits of a well-fitting and esthetic provisional restoration through all phases of construction of the splint bar and the final removable partial denture.     

Provisional prosthodontic appliances in the combination fixed-removable reconstruction

Various combination fixed-removable prostheses have been presented. The construction of the combined provisional prostheses permits the clinician to establish the desired occlusal harmony, esthetics, and jaw relationships, as well as optimal management of the patient. The provisional template allows the clinician to determine patient reaction and response prior to construction of the definitive prostheses. This leads to better clinician-patient rapport and patient satisfaction. Also, it minimizes postinsertion adjustments.     

Provisional restorations in fixed partial prosthodontics

Concepts and techniques for fabrication of various types of provisional fixed restorations have been described. The problems created by less than optimal construction are presented. The clinician must decide which type of fixed provisional appliance is desirable or required in various situations. The same fixed provisional restoration cannot be suitable in every situation. The dentist must be able to evaluate and select which type of interim fixed prosthesis should be constructed for the various cases that present in their offices.     

Fabrication of a fixed provisional restoration utilizing a light-curing acrylic resin.

The properly fabricated provisional restoration must take into account the following interrelated factors: pulpal protection, periodontal health, occlusion, esthetics, and phonetics. The techniques advocated for construction of a provisional restoration include direct, indirect, and a combination of direct and indirect techniques. Two simple techniques that use light-curing acrylic resin for the fabrication of fixed provisional restorations are presented, and advantages and disadvantages of these techniques are discussed.     

Crowns and other extra-coronal restorations: provisional restorations

The important role of provisional restorations is often overlooked. This may be because they are left until the end of an appointment when time for construction is short or because they generally do not need to last for long. However, not only can good provisional restorations help produce better final restorations, they can also save a lot of time and expense at subsequent appointments. In fact time spent in their construction will be more than repaid in time saved doing additional procedures, adjustments and remakes later on.     

Surgical template impression during stage I surgery for fabrication of a provisional restoration to be placed at stage II surgery

The fixture impression method presented permits the construction of a master cast after stage I surgery, enabling the dentist and dental technician to make a provisional crown before stage II surgery. At stage II surgery the surgeon can place the provisional crown instead of a classic abutment or healing cylinder. This eliminates the need for the patient to visit the restorative dentist immediately after stage II surgery for the making of a provisional crown, which can be a scheduling and logistic problem. In addition, better soft tissue contour is possible at stage II surgery, as the premade provisional crown can be shaped to the desired dimensions in the laboratory for ideal esthetics. The soft tissue will adapt to the predetermined surface dimensions during initial healing. Ideal soft tissue contours are present and stable when the final impression is made, which enables better esthetics to be developed for the permanent fixture-retained single-tooth restoration.     

Interocclusal wax impressions for use in provisional and associated fixed prosthodontic procedures

A procedure is presented for the construction of a direct provisional acrylic resin restoration by means of an interocclusal wax impression. This technique requires no preparation or laboratory time and quickly results in a restoration that accurately covers all margins of the preparation and restores proper contact, contour, and occlusion. This procedure can also be used for large restorations, immediate fixed partial dentures, final impressions of preparations, provisional crowns to fit existing removable partial dentures, and some office emergencies.     

Heat-processed acrylic resin provisional restorations: An in-office procedure

A technique has been presented for the construction of a heat-processed acrylic resin provisional restoration. This approach is designed to reduce cost and save time while maintaining esthetics with increased resistance to fracture for prolonged placement.     

Fabrication of treatment restorations using acrylic resin denture teeth

A technique is disclosed for fabricating esthetic, longterm treatment restorations by using acrylic resin denture teeth facings. The advantages of this method for provisional restoration construction are reduced costs and predictable, satisfying results.     

Regaining pleasure and success with complete denture services

The techniques used by Earl Pound for denture construction are stated, and their application to contemporary denture construction and implant-based prosthodontics is discussed. Positioning the anterior teeth using the mandibular movements of speech, the use of lingualized occlusion, and the fabrication of diagnostic provisional removable complete dentures--all hallmarks of the Pound technique--are described. It is the author's experience that many patients are content with properly fabricated conventional dentures and do not require dental implants for retention, comfort, and stability of their prostheses.     

Provisional implants for immediate restoration of partially edentulous jaws: a clinical study

PURPOSE: The aim of this study was to evaluate the use of provisional implants, which can provide patients with provisional fixed partial dentures during the healing time of augmentation procedures and/or during the osseointegration period of definitive implants until delivery of the definitive prosthesis. MATERIALS AND METHODS: Thirty-one patients were consecutively included in the study. Eighteen patients (group A, primary simultaneous group) were initially treated simultaneously with provisional and definitive implants and provided with 18 interim fixed partial dentures. Thirteen patients (group B) received provisional implants in a staggered procedure. In the first stage of group B patients (augmentation phase), provisional implants were placed to bridge the augmentation phase and for anchoring 13 interim fixed partial dentures. In the second stage (secondary simultaneous group), patients of group B received provisional implants to bridge the osseointegration phase for simultaneously placed definitive implants by further use of 13 interim fixed partial dentures. All patients were followed from provisional implant and definitive implant placement to delivery of the definitive prosthesis. Loss of provisional implants and interim fixed partial dentures was noted, and stability of provisional implants was evaluated using the Periotest device. The procedures of immediate rehabilitation with fixed partial dentures using provisional implants were subjectively rated by patients with regard to satisfaction, treatment period, and acceptance. RESULTS: In 31 patients, 44 provisional fixed partial dentures were supported by 98 provisional implants. No provisional implant loss in group A or group B-second stage was observed. Only 3 (3%) provisional implants were lost in group B-first stage during the augmentation phase. Incidence (90.8% versus 9.2%) and stability (Periotest values: 8.6 +/- 3.9 versus 4.8 +/- 2.7) of provisional implants differed significantly between maxilla and mandible (P < .01). All interim fixed partial dentures (n = 44) remained in place for the intended time period but in 3 cases with provisional implant loss they were shortened. No definitive implant loss (n = 94, survival: 100%) and especially no implant loss in cases of maxillary sinus augmentation was seen. The items rated showed high satisfaction and good acceptance of the intensive surgical and prosthodontic program. CONCLUSION: This clinical review showed that (1) provisional implants can successfully provide patients with a fixed partial denture for immediate rehabilitation to bridge the osseointegration or augmentation phase, even in cases with an initially compromised bone situation and (2) although treatment is elaborate, the selected patients decided on a fixed interim rehabilitation with provisional implants rather than on a removable solution.     

Predictable Repair of Provisional Restorations

The importance of provisional restorations is often downplayed, as they are thought of by some as only "temporaries." As a result, a less-than-ideal provisional is sometimes fabricated, in part because of the additional chair time required to make provisional modifications when using traditional techniques. Additionally, in many dental practices, these provisional restorations are often fabricated by auxillary personnel who may not be as well trained in the fabrication process. Because provisionals play an important role in achieving the desired final functional and esthetic result, a high-quality provisional restoration is essential to fabricating a successful definitive restoration. This article describes a method for efficiently and predictably repairing both methacrylate and bis-acryl provisional restorations using flowable composite resin. By use of this relatively simple technique, provisional restorations can now be modified or repaired in a timely and productive manner to yield an exceptional result.

CLINICAL SIGNIFICANCE

Successful execution of esthetic and restorative dentistry requires attention to detail in every aspect of the case. Fabrication of high-quality provisional restorations can, at times, be challenging and time consuming. The techniques for optimizing resin provisional restorations as described in this paper are pragmatic and will enhance the delivery of dental treatment.     

Diagnostic and Technical Approach to Esthetic Rehabilitations

The success of an esthetic rehabilitation depends on the understanding of the patient's needs and on effective communication among the entire dental team. The involvement of the dental technician since the beginning of the treatment plan is one of the keys for success. This article describes a systematic approach to oral rehabilitations involving esthetic areas. Technical suggestions for the construction of the diagnostic wax-up, the provisional, and the final ceramic restorations are illustrated in a logical sequence.     

Diagnostic and technical approach to esthetic rehabilitations

The success of an esthetic rehabilitation depends on the understanding of the patient's needs and on effective communication among the entire dental team. The involvement of the dental technician since the beginning of the treatment plan is one of the keys for success. This article describes a systematic approach to oral rehabilitations involving esthetic areas. Technical suggestions for the construction of the diagnostic wax-up, the provisional, and the final ceramic restorations are illustrated in a logical sequence.     

Immediate placement and immediate provisional abutment modeling in anterior single-tooth implant restorations using a CAD/CAM application: a clinical report

A patient underwent immediate implant placement and immediate provisional restoration with nonocclusal loading in the right central incisor area. A provisional custom abutment and a cemented provisional restoration were fabricated. At the impression appointment, an implant level impression was made and the provisional abutment was scanned for fabrication of the definitive custom abutment. This clinical report describes how CAD/CAM technology can facilitate the definitive restoration of immediately placed and loaded implants by allowing the fabrication of the definitive abutment as an exact duplicate of the provisional abutment.     

Provisional materials: key components of interim fixed restorations

Clinicians have many choices of provisional materials from which to choose when fabricating interim fixed restorations. While traditional materials are still in use today, temporary materials are continuously being updated and improved upon. In addition to the functional necessities required of the provisional material, it must also provide esthetic value for the patient. This article provides an overview of provisional materials, including newer bis-acryls that have helped eliminate some of the challenges associated with traditional acrylic materials. Composite resin preformed crowns for single-unit provisional applications are also discussed, along with CAD/CAM-fabricated materials. Regardless of the material selected, a provisional restoration must maintain and protect the underlying tooth structure from ill effects.     

1998 Judson C. Hickey Scientific Writing Award. Use of a flexible cast for the indirect fabrication of provisional restorations.

Efficient fabrication of a clinically acceptable provisional restoration for a fixed partial denture is an important part of treatment success. Fabrication of provisional restorations that uses the indirect technique produces accurate fitting provisional restorations without the chemical and thermal irritation associated with direct fabrication. With a typodont model, an indirect method is presented that uses an elastic cast for fabrication of multiple unit provisional restorations for fixed partial dentures. The cast is available within 6 minutes of impression making, can be trimmed with a sharp scalpel, and provides flexibility that allows easy separation of the acrylic provisional from the cast. The cast can also be used to evaluate the clinical acceptability of the preparations before impression making. This method has also been successfully used for the fabrication of acrylic provisional restorations for onlay preparations.     

An indirect technique for assuring simplicity and marginal integrity of provisional restorations during full mouth rehabilitation

Full mouth rehabilitation with fixed prosthodontics can be a time- and labor-intensive process. The use of provisional restorations allows the treating clinician to determine the functional and esthetic requirements of the definitive prostheses. However, in the case of full mouth rehabilitation, the individual preparation of provisional restorations for multiple teeth may complicate the provisional phase and increase the treatment time. This article describes a method to simplify the indirect fabrication of provisional restorations for full mouth reconstruction. Provisional restorations may be easily achieved by splinting the provisional restorations in sextants, trimming them according to red pencil marks around the prepared margins as guidelines, and fitting them in the laboratory, utilizing a second set of solid casts for the prepared teeth.     

Use of a customized rigid clear matrix for fabricating provisional veneers.

The fabrication of provisional veneers is time consuming, and may be unpredictable, especially in cases of multiple veneer preparations; however, functional and esthetic provisional veneers, may be used as diagnostic adjuncts for the fabrication of the definitive restoration. This article presents, in a step-by-step procedure, the use of a customized rigid clear matrix with light-cured composite resin as a fast alternative for the fabrication of functional and esthetic provisional composite resin veneers. CLINICAL SIGNIFICANCE: The use of a customized rigid clear matrix for the fabrication of light-cured composite resin provisional veneers has the following advantages: the shape and surface texture produced in the diagnostic wax-up are accurately transferred to the patient's mouth; the provisional restoration is fabricated without violation of the soft tissue and the margins of the preparations; use of the matrix can be repeated when needed; and esthetic and functional provisional veneers can be fabricated relatively quickly.     

Repair of bis-acryl provisional restorations using flowable composite resin

Provisional restorations provide interim coverage for prepared teeth while fixed definitive restorations are fabricated. Several types of autopolymerizing acrylic resins have been used for many years to fabricate provisional restorations. In recent years, bis-acryl resin composite material has gained popularity among clinicians for the direct fabrication of provisional fixed restorations. Occasionally, deficiencies may occur while fabricating a direct provisional restoration and require chairside repair. This article describes an effective procedure for the use of light-polymerized flowable composite resin for the intraoral repair of bis-acryl provisional restorations.