Fabrication of an indirect-direct provisional fixed partial denture
Vincent Bennani, DDSa
School of Dental Medicine, University of Nice Sophia-Antipolis, Nice, France
This article describes a procedure for fabricating an optimal provisional restoration before tooth
preparation. The procedure involves the fabrication of an indirect-direct provisional fixed partial
denture. There are several advantages to this procedure, such as reduced chair time, less heat gen-
erated in the mouth, reduced contact between resin monomer and soft tissues, and optimal
esthetics. (J Prosthet Dent 2000;84:364-5.)
I ndirect provisional restorations are reportedly to
have several advantages. Polymerization of acrylic resin
remote from the prepared tooth and gingival tissues
prevents potential irritation from the acrylic resin
monomer and potential trauma from the exothermic
heat of the polymerization reaction1 and allows in-
creased marginal adaptation when compared with
direct procedures.2,3
This article describes an indirect-direct procedure
for fabricating provisional fixed partial dentures. A cor-
rectly contoured thin-walled provisional restoration is
made in the laboratory before tooth preparation, then
relined directly in the mouth with additional resin. Fig. 1. Diagnostic cast during preparation of teeth. Gingival
The success of this procedure is dependent on the reg- margins with anatomic landmarks.
istration of the gingival margins during the impression
and their preservation during laboratory procedures
and tooth preparation. This anatomic landmark acts as
a link between the laboratory and the clinic.
PROCEDURE
1. Prepare abutments on mounted diagnostic casts.
(The diagnostic cast preparations should be more
conservative than the eventual tooth preparation
and should follow precisely the gingival margins
[Figs. 1 and 2].)
2. Perform a diagnostic waxing procedure on the ar-
ticulated casts so that the completed wax-up
precisely follows the gingival margins (Fig. 3).
3. Complete the provisional restoration using a heat-
polymerizing process.
4. After the acrylic resin has polymerized, finish the Fig. 2. Diagnostic cast after teeth prepared before waxing,
with intact gingival margins.
restoration. The provisional restoration should be
paper thin and correctly contoured, and it should
precisely follow the gingival margins on the cast.
5. Prepare the patient’s teeth in the usual manner (to 7. Reline the temporary restoration to perfect the in-
the gingival margins). ternal fit.
6. Try in the preformed restoration. (If the amount 8. Finish, polish, and cement the restoration.
of tooth reduction is adequate, the provisional
DISCUSSION
restoration will show optimal marginal fit with no
need for adjustment [Fig. 4].) This indirect-direct procedure has several advan-
tages. Chair time is reduced because the restoration is
aAssistantProfessor, Department of Graduate and Postgraduate
fabricated before the patient’s visit, so no or minimal
Prosthodontics. adjustments will be required. In addition, less heat is
364 THE JOURNAL OF PROSTHETIC DENTISTRY VOLUME 84 NUMBER 3
THE JOURNAL OF PROSTHETIC DENTISTRY BENNANI
Fig. 3. Completed wax-up that follows gingival margins. Fig. 4. Teeth prepared for temporary try-in before relining, for
optimal marginal fit.
generated in the mouth because the volume of resin REFERENCES
used during lining is minimal. Another advantage is 1. Moulding MB, Teplitsky PE. Intrapulpal temperature during direct fabri-
cation of provisional restorations. Int J Prosthodont 1990;3:299-304.
that contact between resin monomer and soft tissues is
2. Crispin BJ, Watson JF, Caputo AA. The marginal accuracy of treatment
reduced. restorations: a comparative analysis. J Prosthet Dent 1980;44:283-90.
This procedure provides optimal esthetics because 3. Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed prosthodontics.
1st ed. St Louis: Mosby; 1988. p. 235-60.
the ideal contour is provided from the diagnostic wax-
ing. Color compatibility is improved with the Reprint requests to:
preselected shade. Color stability and good texture are DR VINCENT BENNANI
11, AVENUE FELIX FAURE
improved because heat-cured resin is used to fabricate
06500 MENTON
the external surface form. FRANCE
The only disadvantage of this procedure is the poten- FAX: (33)4-93-57-04-21
tial need of a laboratory phase before tooth preparation.
Copyright © 2000 by The Editorial Council of The Journal of Prosthetic
Dentistry.
SUMMARY 0022-3913/2000/$12.00 + 0. 10/1/109126
This article describes a procedure for fabricating an
indirect-direct provisional fixed partial denture. This
simple procedure achieves functional and esthetic pro-
visional restorations with minimal adjustments and
optimal esthetics. doi:10.1067/mpr.2000.109126
365 VOLUME 84 NUMBER 3
