Long-term reinforced fixed provisional restorations

Extensive prosthodontic treatment often requires fabrication of long-term provisional restorations. Numerous materials and techniques have been described for prolonged insertion of interim restorations. This article describes a procedure for fabrication of long-term reinforced heat-processed provisional restorations based on a diagnostic wax-up. Reinforced heat-processed provisional restorations reduced flexure, which minimizes progressive loss of cement and diminished the possibility of recurrent decay. Occlusal stability and vertical dimension were maintained because of greater wear resistance. Occlusion, tooth contours, and pontic design developed in the provisional restoration were duplicated in the definitive restoration. The use of a matrix from a diagnostic wax-up facilitated fabrication of the prosthesis, and made the procedure less time-consuming and more predictable. (J Prosthet Dent 1998;79:698-701.)     

Indirect provisional restorations

Many methods of provisional restoration fabrication are available to practicing dentists. The indirect method has been found to be the most accurate and least time consuming for the author as well as many other clinicians. After a little practice and familiarity with the methods and materials the restorative dentist will realize the benefits for both the dentist and the patient.     

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.     

Periodontal considerations for provisional restorations

Provisional restorations can cause alterations of tooth form, surface continuity, and the relationship of the restored tooth to the adjacent and opposing teeth as well as the periodontal tissues. As the integrity of the periodontium is of mutual interest to both the periodontist and the restorative dentist, it is important that the potential damage caused by restorative procedures and materials be avoided. Ideally, the provisional restoration should be considered an acrylic progenitor of the final restoration in all aspects except the material from which it is fabricated, its longevity, and the nuances of color and translucency. It should not be replaced by the permanent restoration until all treatment objectives have been accomplished. In an integrated multidisciplinary approach to dental care, it is logical that periodontal treatment precede final restorative procedures. The establishment and maintenance of periodontal health is clearly predicated on an intact dentogingival unit and shallow sulcular dimensions that allow accessibility for removal of plaque. Provisional restorations, whether single or multiple, must conform to and complement the healthy gingival environment if periodontal health is to be sustained. Direct and frequent communication between the periodontist and restorative dentist is a prerequisite for predictable and satisfactory results.     

Color characterization of provisional restorations

Esthetics is required for some provisional restorations. Acrylic resin stains can be used to develop natural appearing restorations with external and internal techniques. The use of a custom-made shade guide aids the dentist in selecting the desired pigment, and determining the need for external or internal staining.     

Reinforced heat-processed acrylic resin provisional restorations

A technique has been described for the fabrication of strong, esthetic, and periodontally considerable provisional restorations. The technique involves cast nonprecious metal frameworks and heat-processed acrylic resin.     

Technique for cementation of provisional restorations

A technique for cementation of a provisional resin splint or crown has been presented. The splint is lubricated with silicone grease and cemented with a noneugenol cement mixed with antibiotic ointment. The grease aids in the complete removal of the cement. The use of a sterile composite resin syringe and preloaded disposable tip allows delivery of the grease to the splint with minimal chance of bacterial cross contamination to the patient.     

The fastest and best provisional restorations

Many options are available for PRs for teeth prepared for crowns, veneers, inlays, onlays or fixed prosthetic abutments. Dentists and dental assistants (where allowed by law) should know the physical properties of the various types of materials and should be able to select and place the appropriate type of PR based on the needs of specific clinical situations.     

Fabrication of provisional acrylic resin restorations

A technique for transitional restoration fabrication has been described. It permits modifications of existing axial and occlusal tooth contours to be accurately reproduced in transitional restorations.     

Custom shade tabs for esthetic provisional restorations

A technique for fabrication of custom shade tabs in tooth form has been presented. The finished product will be a series of custom shade tabs. Any temporary (provisional) resin material can be used.