A new and indirect working die technique for fabricating temporary restorations

A time- and labor-saving indirect method for fabricating temporary restorations that features removable dies (coined the indirect working die technique), is introduced and described. It takes advantage of the accuracy of the traditional indirect method, as substantiated in the literature, but employs new methods and uses materials in a novel way.     

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.     

Provisional restorations for altered occlusions

A method for fabricating provisional restorations with specific criteria has been outlined and offers the following advantages: Altered occlusion can be restored. Select steps can be delegated to auxiliary personnel. Commercial laboratory fees are eliminated. It is inexpensive. The restorations are durable and esthetic. Restorations are readily modified intraorally. This flexible procedure is used for short or long spans, and/or for segmented treatment. Casts of acceptable anterior provisional restorations can provide a template for developing anterior guidance in the final restorations.     

A direct technique for fabricating esthetic anterior fixed provisional restorations using polycarbonate veneers

Fabrication of esthetic interim restorations by a chairside technique often challenges the clinician with regard to the required time and skills, as well as meeting the expectations of the patient. Autopolymerizing polymethyl methacrylate resin has been reported to be the most popular material for fabricating provisional restorations. However, this material does not routinely yield esthetic provisional restorations via a chairside technique. This article describes a simple technique to overcome some of the disadvantages of this material by using prefabricated polycarbonate facings backed with autopolymerizing acrylic resin. This technique can be used chairside for fabricating esthetic anterior interim restorations, utilizing the beneficial properties of both materials. It exploits the manufactured smooth-surface finish, superior esthetics, color stability, and durability of polycarbonate facings, as well as the marginal adaptation, strength, and low cost of autopolymerizing acrylic resin.     

Direct technique for the fabrication of a visible light-curing resin provisional restoration

A properly fabricated provisional restoration will, among other things, provide acceptable esthetics. Although many materials have been used for provisional restorations, when esthetics is of primary concern, the choice is limited to tooth-colored resin materials. Recently, a tooth-colored, light-activated urethane dimethacrylate resin has been developed. This material has been reported to be useful for many prosthetic applications, including the indirect fabrication of provisional restorations. This paper presents a technique for the direct fabrication of single-unit provisional restorations using this material. The physical properties of this resin and the advantages and disadvantages of the technique are also discussed.     

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.     

Clinical evaluation of a visible light-cured indirect composite for long-term provisionalization

OBJECTIVE: To clinically evaluate a visible light-cured (VLC) resin composite system for long-term provisional and esthetic diagnostic restorations, fabricated using indirect techniques. METHODS: One-hundred and nine teeth were restored in 31 patients. Preoperational impressions were used to create VLC resin composite restorations (Radica) using indirect techniques. Restorations were relined as necessary and placed using various provisional cements at a follow-up appointment, subsequent to preparation of the teeth. Both fabricating laboratory technicians and placing dentists rated the restorations for acceptability in esthetics, marginal fit, occlusion, and functionality in various stages of provisionalization. RESULTS: All restorations (100%) were rated acceptable for esthetics prior to relining. After relining, a majority (93-100%) of restorations were rated acceptable in esthetic and functional criteria. At the placement of the permanent restoration, a majority (96-100%) of restorations were rated acceptable in esthetic and functional criteria. Terms of service ranged from two to seventy-six days. CONCLUSION: In combination with in vitro results, the clinical performance of the Radica VLC system for provisionalization and esthetic diagnostic restorations was judged to be acceptable. The system offers esthetics that are superior to conventional provisional restorations, and should be a valuable option to practitioners considering longer-term provisionalization in complex cases.     

Direct technique for the fabrication of acrylic provisional restorations

Provisional restorations are fabricated to protect the prepared tooth structure during the period between tooth preparation and insertion of the definitive restoration. These restorations are also referred to in the literature as interim, temporary, or provisional restorations (prostheses). Such restorations should be uncomplicated and inexpensive to fabricate in a short period of time. Several laboratory and clinical techniques for the fabrication of provisional restorations have been described in the literature, such as the indirect technique, direct technique, and indirect-direct techniques for both single and multiple unit restorations. This article describes a step by step clinical technique for the fabrication of a direct provisional restoration to satisfy the issues of esthetics, patient comfort, speech and function, maintenance of periodontal health, and maxillomandibular relationships while wearing the restoration.     

Fabrication of Acrylic Resin Copings for CeraOne Provisional Restorations

A technique is described for fabricating autopolymerizing acrylic resin copings for CeraOne provisional restorations. This method has the advantage of providing a chemical bond rather than only a bond between the mechanical coping and the relined provisional crown, as is the case when using the provisional components supplied by the manufacturer. The technique describes provisionalization at the time of stage II surgery. This type of coping can also be used after a period of soft tissue healing when a healing abutment is employed. The benefits of the procedure include increased patient satisfaction and reduced chair time for repairs.     

Composite indirect-direct method for fabricating multiple-unit provisional restorations

This article describes a method for fabricating multiple-unit provisional restorations by use of the indirect-direct method without the need for abutment preparation on diagnostic casts. Composite is used with fiber reinforcement to create a provisional shell in a vinyl polysiloxane matrix. This method reduces chair time, as well as laboratory time required to fabricate provisional restorations. Control of restoration contours and incisal edge position is also enhanced.     

A simple and predictable direct technique for esthetic provisional veneers

There are a number of different techniques for fabricating provisional veneers. There are direct and indirect techniques involving acrylic or composite resin veneers made with or without a vacuform matrix. This article describes a direct technique for fabricating removable provisional veneers using an auto-polymerizing urethane dimethyacrylate resin and a thermoplastic matrix that may later serve as a stent to be worn with the provisional veneers.     

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.     

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.     

Indirect implant-supported fixed provisional restoration in the esthetic zone: fabrication technique and treatment workflow

Treatment objectives of an implant-supported fixed provisional restoration include shaping/preservation of the gingival soft tissue contour, functional and esthetic substitution of the missing dentition during postsurgical healing, and definitive prosthesis fabrication stages. Fixed provisional restoration can also serve as an esthetic and functional blueprint in the fabrication of the definitive restoration. Despite its common use and important indications, limited information is available on the various aspects of the provisional fabrication and treatment. This article presents a production technique and treatment workflow of a laboratory-fabricated, screw-retained fixed provisional restoration. Provisional restoration is fabricated using layering technique and internal stain characterization. The soft tissue profile of the working cast is modified according to the coronal contour of the diagnostic wax-up. Upon delivery, the provisional contour is reevaluated and modified as necessary. The developed emergence profile of the provisional restoration is transferred to the master cast via customized impression copings. CLINICAL SIGNIFICANCE: Laboratory-fabricated implant-supported provisional restorations allow the esthetic and functional substitution of the missing dentition and the shaping of the soft tissue profile, and can act as a blueprint in the fabrication of definitive restorations.     

Direct pressure provisionalization technique: a new open-tray technique for complete-arch rehabilitations.

An innovative direct technique that improves the accuracy of provisional acrylic resin restorations is introduced. A custom impression tray is modified to facilitate complete occlusal closure. This open tray is used to make an accurate overimpression prior to beginning tooth preparation procedures. Following tooth preparation, the acrylic resin-filled overimpression is returned to its intraoral position, and the patient occludes into the previously indexed impression material. The pressure overimpression technique is offered as an expedient technique for improving the accuracy of provisional restorations.     

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.     

Treatment of completely edentulous patients with fixed implant-supported restorations: three consecutive cases of simultaneous immediate loading in both maxilla and mandible

This article aims to: (1) describe the treatment of three consecutive completely edentulous patients with fixed implant-supported restorations, including simultaneous same-day immediate loading with fixed provisional restorations in both jaws; and (2) illustrate a step-by-step definitive restoration approach. All patients followed the same diagnostic protocol. One surgical intervention was performed for simultaneous implant placement in both maxilla and mandible. Following implant placement, all patients received a simultaneous, same-day, complete-arch, screw-retained provisional restoration in both jaws according to the "pickup" technique. After healing, final impressions were taken, and occlusion recorder devices were prepared on working casts. For the first occlusal record, the "half-provisionals" method was used. Definitive solid abutments were used for both laboratory and clinical procedures. After casting and finishing, the frameworks were tried in, and a new occlusal record was made. The definitive segmented restorations consisted of four fixed partial dentures in the maxilla and three in the mandible and were cemented with provisional cement. All patients received a nightguard. The pickup technique facilitated simultaneous immediate loading in both maxilla and mandible. A complete, fixed, segmented rehabilitation supported by six to eight anteroposterior implants is a reproducible treatment for completely edentulous patients when optimal anatomic conditions are present.     

Immediate provisional restorations to aid in gingival healing and optimal contours for implant patients

A procedure for making an impression at stage I implant surgery is described, and the sequential laboratory procedures for fabricating a custom provisional restoration are presented. The provisional restoration is delivered at the uncovering of the implant, providing a template for the tissue healing with desired contours. This procedure facilitates the fabrication of implant restorations with optimal gingival contours and esthetics.     

Multiple cast post and cores for severely worn anterior teeth

A technique has been presented to simplify the fabrication of multiple direct post and core patterns. When combined with techniques for indirect provisional restorations, this technique merely requires the fabrication of an additional plastic template to form the direct core patterns.