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Flashcards in Interim Restorations: Dr. Al Deck (21)
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1

Interim Restoration: Define

  • prosthesis designed to enhance
    • esthetics
    • stabilization
    • and/or function
  • for limited period of time
  • then replaced by definitive prosthesis

2

Are interim restorations essential to fixed prosthodontic treatment?

Yes, since restorations are fabricated indirectly in the lab.

3

Interim Restoration requirements

  • Same as permanent restorations, except longevity and color
  • protect the prepared teeth
  • Maintain periodontal health
  • maintain Occlusal stability and tooth position
  • Restore masticatory function
  • Maintain Phonetics
  • Restore esthetics

4

Protect the prepared tooth

  • irritation from bacterial plaque and saliva
  • exposure to irritating and painful stimuli
  • abrasion or break prepared tooth surfaces

5

Maintain periodontal health

  • Maintain:
    • non-impinging margins
    • proper contours, emergence profiles, and embrasures
    • proper surface texture and finish

6

Maintain intra- and inter-arch tooth stability

  • occlusal contacts
  • proximal contacts
  • inter-abutment stability

7

Restore Masticatory function

  • Centric occlusal contacts
  • lateral and protrusive guidance

8

maintain phonetics through

 

  • tooth position
  • tooth length

9

Restore esthetics

  • proper contours for facial support
  • proper tooth form for dental appearance
  • tooth shade compatible w/remaining teeth

10

What are the Interim Fabrication techniques

  • Direct Technique
  • Indirect Technique
  • Digitally fabrication provisonal restoration

11

Direct Technique

  • Made intra-orally directly on patient 
  • based on diagnostic wax up or the tooth before prep
  • Advantage:
    • Convenience
    • less time for fabrication

12

Indirect technique

  • made in lab on cast of prepared teeth
  • Advantages:
    • decreased irritation to pulpal and gingival tissues
    • patient comfort/allergies
    • presence of multiple undercuts
    • long span or multiple unit prostheses

13

Digital technique

  • Digitally designed on a softwared
  • then milled out of a block
  • Advantage:
    • advantages of both direct and indirect techniques
    • Better adaptation
    • stronger material

14

Type of Interim Restorations

  • Preformed crowns:
    • Single unit restorations
  • Custom Mold
    • single or multiple unit restorations

15

Prefabricated crown forms

  • Material
    • Polycarbonate
    • Aluminum
    • Stainless Steel (pedo)
  • Limited to single units
  • Must be lined with autopolymerizing resin
  • Good amount of modification may be required 
    • internal relief
    • axial recontouring
    • occlusal adjustment
  • Emergency 1st visit when crown is missing

16

Custom Molded forms: 

  • Materials:
    • Vacuum formed matrix
    • Silicone putty matrix
    • alginate impressions or other impression materials
  • Less time consuming
  • single or multiple units
  • improved contours and esthetics
  • simulates planned restoration 
    • when used in combo w/diagnostic wax up

17

Available Materials for interim restorations

  • Acrylic Resins
    • Polymethyl methacrylates (PMMA)
  • Bis-Acryl Composites
    • Chemically-activated
    • Visible Light-Activated
    • Dual-Activated

18

PMMA Acrylic Resins: Advantages vs Disadvantages

  • Advantages:
    • low cost
    • good wear resistance
    • good esthetics
    • high polishability
    • can be relined and repaired
  • Disadvantages
    • exothermic reaction
    • high degree of shrinkage (8%)
    • strong, objectionable odor
    • must be hand mixed

19

Bis-Acryl Composites: Advantages vs Disadvantages

  • Advantages:
    • less shrinkage
    • minimal heat generated during setting
    • minimal odor
    • most products use automix delivery
    • easy to trim
  • Disadvantages:
    • increased cost
    • air inhibited layer present after polymerization
    • looses surface luster with time
    • more brittle than acrylics
    • difficult to reline/repair

20

Problems associated with Interim Restorations

  • Time required for fabrication
  • Time interim restoration is in oral cavity
  • materials available for interim restorations

21

Diagnostic Importance of Interim Restoration

  • Verify Adequate prep
  • determine if the planned restoration will satisfy functional, esthetic, and phonetic requirements of the patient
  • determine the response of gingival tissues to planned restoration and facilitate perio therapy via:
    • improved access
    • improved contours
    • emergence profiles & embrasures