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Fixed Pros I > Provisional Restorations > Flashcards

Provisional Restorations Flashcards

1
Q

what is a provisional

A

a prosthesis designed to enhance esthetics, stabilization and/or function for a limited period of time after which it is to be replaced by a definitive prostheses

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2
Q

what is a provisonal used for

A

to assist in determination of the therapeutic effectiveness of a specific treatment plan or the form and function of the planned definitive prosthesis

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3
Q

what is the advantage of digital dentistry

A

provisionals are not needed when you can digital scan and mill in the office as the patient leaves the office with a cemented definitieve restoration

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4
Q

what are the functions of a provisional restoration

A
  • prevent sensitivity
  • prevent drifting
  • allow tissues to heal
  • return function to dentition
  • esthetics
  • diagnostic evaluations
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5
Q

what are the requirements of a quality provisional

A
  • pulpal protection
  • positional stability
  • occlusal function
  • ability to clean
  • marginal integrity
  • strength and retention
  • esthetics and phonetics
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6
Q

how do provisional restorations protect the prepared teeht

A
  • protect against plaque and saliva
  • protect against irritating and painful stimuli such as temperature changes and chemicals/fluids
  • protect against abrasion or breakage of prepared tooth
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7
Q

what provides positional stability of the provisionL

A

-proximal contacts
- occlusal contact
- inter-abutment stability with a bridge

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8
Q

a provisional will prevent _____ drifting of the prepared and/or adjacent eeth

A

lateral

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9
Q

a provisional with open contacts will allow:

A

food and debris to impact in between

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10
Q

what do open contacts lead to

A

short term discomfort and pain
- periodontal inflammation and possibility of too much bleeding to be able to seat the crown when patient returns

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11
Q

without appropriate contacts on your provisional:

A

there is a good chance the teeth will shift collapsing the vertical between your preparation and opposing

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12
Q

what does lack of occlusal contact result in

A

extrusion

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13
Q

what will happen when trying to seat definitive crown if provisional is too low

A

the crown will be high
- material can be thinned and weaker, anatomy destroyed and crown cant function appropriately in the occlusal scheme of the patient

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14
Q

if the temporary is too high:

A

there will be pain, possible loss of the temporary or a breakage of temporary

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15
Q

describe the ideal occlusal contacts

A
  • ideal centric occlusal contacts
  • lateral and protrusive guidance where appropriate (anterior teeth)
  • no contact in lateral or protrusive on posterior teeth
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16
Q

describe the provisonal/peridontal interaction

A
  • non- impinging margins
  • physiologic contours, emergence profiles, embrasures, and proximal contacts
  • smooth surface texture and finsih
  • all these lead to optimum periodontal health and predictable crown delivery
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17
Q

describe provisional marginal integrity

A
  • fit as close to the finish line of the tooth as possible
  • shape the contour to make it smooth and undetectable with an explorer with a smooth surface finish
  • seal the provisional at the margin to prevent pain, sensitivity or dislodgement
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18
Q

how should the emergence profile on the provisional look

A

flat or slightly concave not convexed or bulging

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19
Q

what does a rough margin lead to

A

plaque accumulation and gingival inflammation

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20
Q

what does bleeding gums pose a challenge to

A

impressions and crown seating

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21
Q

need adequate _______ for strength

A

thickness of material

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22
Q

what allows for adequate thickness of temporary

A

adequate tooth reduction

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23
Q

what is the #1 reason temporaries break

A

occlusion

24
Q

describe bis-acryl

A
  • easy to use and easy to trim and polish
  • is a brittle material which can fracture if occlusal load is too strong and if material is too thin
25
Q

describe provisional esthetics and phonetics

A
  • maintain phonetics
  • facial lip support
  • proper tooth form and appearance
  • tooth shade compatible with remaining teeth
  • provisionals can be a preview of final restorations to enhance patient acceptance
26
Q

how can phonetics be maintained with temporaries

A

-proper tooth length
- position
- contours

27
Q

describe interim fabrication

A
  • material is placed in a matrix while in a fluid state
  • matrix is placed on tooth and allowed to solidify
  • matrix is trimmed and polished while material continues to harden
  • must continually place temporary on preparation or temporary will not fit
  • most interim materials shrink as they solidify
28
Q

describe direct interim fabrication

A
  • create matrix prior to prep
  • prepare tooth
  • place temp material in matrix and seat in mouth
  • remove, trim, and adjust
  • cement
29
Q

the _______ forms the external portions of the interim while the ______ forms the internal of the interim

A

matrix; preparation

30
Q

what are the 2 types of interim restorations

A

-external surface forms
- directly on tooth versus indirectly on cast

31
Q

what are the external surface forms

A

pre-fabricated (preformed) crowns (singles)
custom fabricated molds (multiple)

32
Q

what are the temp prefabricated crowns

A
  • aluminum or tin-silver
  • stainless steel
  • polycarbonate shells
  • cellulose acetate shells
  • VLC moldable crowns
33
Q

describe pre-fabricated crown forms

A
  • limited to single units
  • must be lined with auto-polymerizing resin
  • considerable modification needed for appropriate fit and contour
  • best when patient in your office with crown off and lost or broken tooth with not enough tooth to make a traditional matrix form
34
Q

describe custom molded interims

A
  • less time consuming
  • can be used for singles but required for multiple units
  • improved contours and esthetics
  • simulated planned restorations when used with diagnostic wax up
35
Q

describe the direct technique

A
  • convenient
  • time required for fabrication - routine restorations
36
Q

describe indirect technique

A
  • patient comfort
  • if presence of multiple undercuts, allows you to see this before it gets stuck in patient mouth
  • great of long span bridges or multiple units
  • can be fabricated ahead of time in advance of the tooth prep appointment
37
Q

describe lab fabricated shell provisional

A
  • typically used for multiple units or full arch provisionals
  • shell is thin and will be relined in the mouth
  • made prior to preparations
  • saves time on big cases
  • not cheat, can be several hundred dollars
  • can also mill temporary shells in office with some systems
38
Q

what are the currently used materials for provisionals and what brands of each

A
  • acrylic resins: PMMA Jet acrylic, Powder/liquid formulations
  • Bis-Acryl composite resins: Bis-GMA containing materials, chemically activated, light activated
39
Q

what are the advantages and disadvntages of PMMA

A
  • A: good marginal fit, good strength, good polishability, durability
  • D: high exothermic heat increase, low abrasion resistance, free monomer toxic to pulp, high volumetric shrinkage
40
Q

what are the advantages and disadvantages of Bis-acryl

A
  • A: good marginal fit, low exothermic heat increase, good strength, low shrinkage, good surface hardness and abrasion resistance, good biocompatibility, color stability and patient acceptance, can light cure
    -D: surface hardness, less stain resistance, limited shade selection, limited polishability, brittle, high cost, brittleness, no rubbery stage
41
Q

describe PMMA (jet acrylic) temporary material

A
  • chemical conversion of monomer to biologically inert polymer is through a chain reaction
  • unreacted free monomer is toxic
  • inadequate polymerization results in poor mechanical properties
  • polymerization is exothermic and there is shrinkage upon polymerization and cooling
42
Q

what properties are associated with monomer im PMMA

A

chemical or allergic reaction

43
Q

what properties of set material for OMMA

A
  • exothermic reaction
  • volumetric shrinkage
  • increased strength due to polymerization
44
Q

what are the properties of polymer in the powder in PMMA

A
  • with proper amount we have strength and handling
  • too little poweder- loss of strength
  • too much powder- poor handling and adaptation
45
Q

what are the problems with interim restorations

A
  • time to fabricate
  • length of time temp is required in the mouth
  • materials are good but not great
  • managing deficiencies: relining or repairing
46
Q

how should you treat fractured surfaces

A
  • grind to expose a fresh surface
  • roughed this fresh surface
  • composite flowable resin to repair
47
Q

describe Zinc oxide eugenol

A
  • temp bond
  • low strength
  • eugenol is a sedative for tooth
  • eugenol can inhibit resin polymerization
48
Q

when would you not use eugenol

A

core buildup or anything with resin because it inhibits polyermization

49
Q

what are the non-eugenol cements

A
  • polycarboxylate cement (ultratemp)
  • glass ionomer based cement (smart temp)
  • resin cement (telio)
50
Q

what are the types of cements

A
  • eugenol
  • non-eugenol
51
Q

what is the only eugenol cement

A

zin oxide eugenol

52
Q

describe ultratemp

A

low strength

53
Q

describe smart temp

A

longer term temporary use

54
Q

describe telio

A

translucent

55
Q

what are the steps to cementation

A

mix equal parts of base and catalyst on mixing pad with spatula

56
Q

when should you check the occlusion and why

A

after cementation because the cement thickness can inhibit full seating of the provisional

57
Q
A

Fixed Pros I (13 decks)

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