Simplified procedure for provisional fabrication

Simplified procedure for provisional fabrication Linda J. Thornton, DDS, MSa School of Dentistry, Temple University, Philadelphia, Pa.

During the period between tooth preparation and fixed partial denture cementation, a provisional restoration protects the teeth, maintains space, and keeps the patient comfortable. Numerous methods for fabricating provisional restorations have been reported.1 This tip presents a modification of the vacuum-formed template method. A siloxane-lined matrix is used to capture occlusal anatomic detail and contour.

PROCEDURE 1. Make a preliminary quadrant irreversible hydro-colloid (Jeltrate Plus; Dentsply, Milford, Del.) impression of the area to be restored. Either plaster or stone can be used to fabricate the working cast. 2. After placing a denture tooth into the edentulous space on the working cast, make a thermoplastic matrix of the area to be provisionally restored. After the thermoplastic material has been adapted to the cast, trim the matrix. The borders must cover at least half of the occlusal and incisal surfaces on the teeth adjacent to the area being restored and extend one-half of the distance between the gingival crest and soft tissue vestibule. 3. Lightly lubricate (Vaseline; Chesebrough-Pond’s USA Co, Greenwich, Conn.) the cast, and coat the area that will serve as the provisional restoration with vinyl polysiloxane impression material (Mach-2; Parkell, Farmingdale, N.Y.). Do not cover the teeth adjacent to those involved in the provisional restoration. The resulting product will be a siloxane-lined matrix that captures occlusal anatomic detail and contour (Fig. 1). 4. After the abutments have been prepared, make an irreversible hydrocolloid impression of the provisional area, and pour it in the vinyl polysiloxane impression material. The siloxane working cast should include accurate replicas of the teeth and soft tissues with at least one tooth on either side of the prepared teeth (Fig. 2, A). 5. Fill the template with a mixture of the desired shade of autopolymerizing acrylic resin (Snap; Parkell, Farmingdale, N.Y.), and place it on the siloxane working cast. Press down on the clear, unlined oca

Assistant Professor, Department of Restorative Dentistry. J Prosthet Dent 2002;88:230-1.

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Fig. 1. A, Placement of siloxane material on stone cast. B, Trimmed matrix. Arrows indicate location of borders. Top arrows show coverage of one-half of occlusal surface; bottom arrows show end of coverage between gingival crevice and vestibule. C, Clear and lined matrices.

clusal areas on the matrix and allow the material to set (Fig. 2, B). VOLUME 88 NUMBER 2

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THE JOURNAL OF PROSTHETIC DENTISTRY

Fig. 2. A, Siloxane working cast. B, Lined matrix filled with autopolymerizing resin positioned over siloxane working cast.

REFERENCE 1. Shillingburg HT, Hobo S, Whitsett LD, Brackett SE. Fundamentals of fixed prosthodontics. 3rd ed. Chicago: Quintessence; 1997. p. 226-45.

Reprint requests to: DR LINDA J. THORNTON RESTORATIVE DEPARTMENT TEMPLE UNIVERSITY SCHOOL OF DENTISTRY 3223 N BROAD ST PHILADELPHIA, PA 19140 FAX: (609)714-9369 E-MAIL: [email protected]

Fig. 3. Completed provisional restoration.

After removing and trimming the provisional, reline it intraorally for marginal adaptation. The provisional restoration will provide definitive anatomy with minimal occlusal adjustments (Fig. 3).

AUGUST 2002

Copyright © 2002 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/2002/$35.00 ⫹ 0 10/1/121828 doi:10.1067/mpr.2002.121828

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