OPTEC-provisional restorations

Question 1

What can provisional restorations be used for?

Answer 1

• Checking the tooth preparation
• providing occlusal Stability
• Preserving or improving function (mastication and speech)
• Aesthetics

Question 2

How does tooth preparation affect the teeth?

Answer 2

Compromises aesthetics in the smile line

Degrades tooth function

Destabilises the occlusion

• Reduced occlusion makes teeth want to overerupt to contact again.
• The increased interproximal space makes teeth want to tilt towards each other in the space.

It makes them more sensitive (as the dentine is exposed)

It compromises the coronal seal of root canal treated teeth.

Question 3

What do you check to confirm the tooth preparation?

Answer 3

• The thickness of the provisional restoration using a svensen gauge.
• Check for undercuts

Question 4

What is the emergence profile?

Answer 4

This is the shape of the tooth as it exits the gingivae.

Question 5

Why is the establishment of a gingival contour important?

Answer 5

For the correct aesthetics.

If the provisional restoration is flat, the gingivae will collapse (not aesthetic).

Therefore, we want a contour on the provisional that pushes out slightly, this props up the gingivae causing it to remodel around the tooth.

Question 6

Compare the different options for preformed provisional restorations

Answer 6

Polycarbonate- this is sublined with acrylic.(Used for anteriors and premolars)

Clear plastic- that you fill with composite then peel off the plastic (used for anteriors and premolars)

Preformed metal provisional- aluminimum or stainless steel- this is used for posterior teeth. (Sharp margins can cause trauma.

Question 7

Discuss the advantages and disadvantages of pre-formed provisional restorations.

Answer 7

Adv- good if you were unable to take an impression of the tooth before begining treatment

Disadv- unlikely to fit properly & you need a large bank of crowns to accomodate the variation between patients.

Question 8

How can we provisionally replace a missing tooth?

Answer 8

• A bridge made of provisional material
• Acrylic stents with pontic
• Essix retainer with pontic
• A denture
• Preimplant
• Pre bonded bridge (not enough preparation for a provisional to fit onto
• Leave the space and provisionalise the abutment tooth

Question 9

Why do we not leave edentulous spaces in a young person?

Answer 9

Because the teeth are less stable in younger people so there is a greater risk of overerruption or tipping.