PROVISIONAL RESTORATIONS or
TEMPORIZATION
CONTENTS
● Definition
● Requirements of provisional restorations
● Types of provisional restorations
● Material requirements
● Steps in fabricating provisional restorations
● Custom and preformed matrix
● Recent advances
● Limitations
● Conclusion
Synonyms
Provisional,interim prosthesis, temporary
prosthesis,transitional restoration, treatment restoration,
intermediate restoration
Definition
A fixed or removal prosthesis designed to enhance
esthetics stabilization and function for a limited period of
time after which it is to be replaced by definitive
prosthesis.( GPT- 8 )
Requirements of provisional restoration
BIOLOGICAL
● Pulp protection
● Periodontal
health
● Positional
MECHANICAL stability AESTHETIC
● Functional ● Prevention of ● Contourable
● Loss of fracture ● Colour
retention stability
● Removal for ● Translucent
reuse ● Texture
Classification
According to method of fabrication:
● Preformed
● Custom made
According to material used:
● Resin :
Preformed (Polycarbonate, Cellulose acetate)
Custom made (Acrylics, Bis-acryl composites)
● Metals:
Preformed (Aluminium, Tin silver, Nickel chromium)
Custom made (Cast metal alloy)
According to duration of use:
● Short term.
● Long term.
According to technique of fabrication:
● Direct technique.
● Indirect technique.
PROVISIONAL RESTORATION MATERIAL
Ideal requirements:
● Adequate strength and wear resistance.
● Biocompatible.
● Good dimentional stability.
● Easy to contour and polish.
● Odourless and non-irritating.
● Chemically compatible with luting cement.
● Esthetically acceptable.
● Adequate working and setting time.
● Easy to repair.
CUSTOM MADE PROVISIONAL RESTORATION
● The anatomic form and shape of tooth being restored is
fabricated by dentist.
● Provides intimate contact between a provisional restoration
and prepared tooth.
Advantages Disadvantages
● Most versatile ● Time consuming
● For any clinical situation ● Additional lab procedure
● Better fit involved
CUSTOM MADE PROVISIONAL RESTORATION
Polymethyl methacrylates
Material used:
Resin :
1. Acrylics Poly-R’ methacrylates
● Polymethyl methacrylate
● Poly-R’ methacrylate
2. Bis- acryl composites Bis-acryl composites
● Chemically activated
● Light activated
● Dual activated
Metals : Cast metal alloy
PREFORMED PROVISIONAL RESTORATION
● The anatomic form is prefabricated and readily available in
different tooth types and sizes.
● The appropriate type is selected, modified and mostly
relined to fit the prepared tooth.
Advantages Disadvantages
● Less technique sensitive to ● Cannot be used for FPD’s
fabricate. ● Most types need modification
● Requires less chairside time. to fit the preparation
PREFORMED PROVISIONAL RESTORATION
Depending on the types of Material Used:
Resin based provisional restoration
● Cellulose acetate
● Polycarbonate
● Poly methyl methacrylate
● Poly-R methacrylate
● Microfilled composite
● Urethane dimethacrylate
Metal provisional restoration
● Aluminium
● Nickel- Chromium
● Tin- Silver
RESIN
Polycarbonate crowns:
● They combine microglass fibers with polycarbonate plastic
material.
● As a matrix material around a prepared tooth .
● It possesses high impact strength, abrasion resistance, and
good bond with meth acrylate resin.
● Best esthetic among all preformed crowns.
● Available in shape of incisor, canine, and premolars in
varying size
Cellulose acetate:
● It is thin, soft, transparent scaffold material.
● Available in all tooth shape and different sizes.
● It does not bond to the relining resin.
● An approximately size of this crown is selected from a
mould guide and filled with autopolymerizing resin of
appropriate shade.
● This is inserted over the lubricated prepared tooth.
METALS
Aluminium and tin-silver:
● Generally limited to posteriors for esthetics reasons.
● Available as simple shell.
● They provide good adaptation due to softness and
difficulty of the material, but can also promote rapid wear
resulting in perforation.
● They may be relined with resin to obtain better fit and
rigidity and then luted to prepared tooth.
Nickel- Chromium:
● Indicated for use in children with damaged primary teeth.
● They need not to reline with resin.
● They are trimmed, contoured, and adapted to the tooth.
● Strong cements are used for luting.
BASED ON DURATION OF USE
Short-term temporary Long-term temporary
restoration restoration
● Most common ● Maybe used for few months.
● Used upto 2 weeks ● Usually cast metal is indicated
● Cast metal is not used-all ● Long span posterior FPD
other preformed & custom- ● Prolonged treatment time
made materials can be used ● If patient is unable to avoid
● As interim restoration in excessive forces on
crowns and FPDs. prosthesis.
PROVISIONAL RESTORATIONS FABRICATED
USING DIRECT TECHNIQUE
PROVISIONAL RESTORATIONS FABRICATED
USING INDIRECT TECHNIQUE
PROVISIONAL RESTORATIONW FABRICATED
USING DIRECT-INDIRECT TECHNIQUE
DIRECT TECHNIQUE INDIRECT TECHNIQUE
● Remove from mouth before it ● No need to remove before it
is completely polymerized. is completely polymerized.
● Less better marginal fit ● Not present
● Chances of thermal insult of ● Not present (because
the pulp exothermic reaction occurs
on the patient’s stone model
CEMENTATION OF PROVISIONAL RESTORATION
IDEAL PROPERTIES OF CEMENT:
● Ability to seal against leakage of oral fluid.
● Strength consist with intentional removal.
● Low solubility.
● Chemical compatibility with provisional polymer.
● Ease of eliminating excess.
● Adequate working time and short setting time.
CEMENTS USED:
● Zinc oxide eugenol.
● Reinforced zinc oxide eugenol.
● Non- eugenol cements.
Zinc phosphate, Zinc polycarboxylate, and Glass ionomer cements are not used
because their comparatively high strength makes intentional removal difficult.
RECENT ADVANCES IN PROVISIONAL MATERIALS
● CAD CAM based longterm temporary materials
● Composite based temporary materials
● Integrity temp
● Rubberized urethanes
CAD-CAM MILLED RESIN BLOCKS
● Superior marginal fit – lowers the risk of bacterial
contamination of the tooth and prevents damage to pulp
from excessive temperature changes.
● Stronger and more accurate (industrial polymerized).
● Good mechanical properties.
● Serves as a solution for long-term/long-span interim
prosthesis where strength and colour stability is required.
● Easy to manipulate.
● Material for their fabrication is Polymethyl methacrylate
(PMMA). Polymethyl methacrylate blocks combined with
digital processes reduce several obstacles that are
present in process of making direct temporary
restorations.
LIMITATIONS OF PROVISIONAL RESTORATION
● Lack of adequate strength—fracture of provisional is
possible in long span FPDs, patient with bruxism and
reduced interocclusal clearence.
● Inadequate marginal adaptation.
● Poor aesthetic in long term provisional restoration.
● Plaque accumulation due to poor surface characteristic.
● Compromised bonding characteristics.
● Mild to moderate tissue irritation
CONCLUSION
● The high quality esthetic dentistry should take advantage
of all these technological developments in order to
improve the esthetic expectations of our patients.
● The construction of high quality provisional restorations
may help all the professionals to do the work in a fast and
efficient way with consideration for the natural esthetics of
the teeth.
