Provisional Restorations made it easy Paulo Monteiro Clinical case style italiano styleitaliano

Provisional Restorations made it easy

Provisional restorations are one of the mandatory steps for an indirect restoration, especially in the anterior area, when the patient needs some temporary restoration because of the aesthetic and function.
There are different ways to make the provisional restoration. The bis-acryl resins are one of the most easy ways to fabricate it. Different advantages as easy handling, fast setting, repair, polishing and aesthetics turn this material one of the most popular for this propose nowadays.

initial situation styleitaliano style italiano clinical case Paulo Monteiro

Fig.1

Patient come to the office after a trauma on the tooth 21.
After the clinical examinations and RX the vitality was compromised and the endodontic treatment had to be
made.

endodontic treatment performed Paulo Monteiro style italiano styleitaliano

Fig.2

Endodontic treatment performed on the tooth 21.

Shade selection for the communication with the dental lab

Fig.3

Shade selection for the communication with the dental lab. Shade A2 Vita Classic was selected for the final
crown.
The shade should be selected in the beginning of the appointment with the teeth hydrated.

Tooth 21 after preparation for a ceramic crown style italiano clinical case

Fig.4

Tooth 21 after preparation for a ceramic crown.

Application of the astringent retraction paste to have some deflection and space for the impression material

Fig.5

Application of the astringent retraction paste to have some deflection and space for the impression material.

Astringent retraction paste placed to have some deflection and space for the impression material

Fig.6

Astringent retraction paste placed to have some deflection and space for the impression material.

Protemp 4 bis-acryl resin applied inside the silicon index

Fig.7

Protemp 4 bis-acryl resin applied inside the silicon index.
The silicone index (Express Putty fast set) was fabricated by the previous wax-up shape.

The bis-acryl resin used to make the provisional crown (Protemp 4) style italiano clinical case

Fig.8

The bis-acryl resin used to make the provisional crown (Protemp 4).

Protemp 4 bis-acryl resin applied inside the silicone index

Fig.9

Protemp 4 bis-acryl resin applied inside the silicone index.
The mixing tip should be not removed from the silicone index until all the tooth space are filled, in order to avoid internal voids.
After place the index in the mouth we should wait till the gel phase to remove the excess of material. Then keep the index in the mouth for more two minutes and we can remove the silicone index and make the polishing procedures.

Portemp 4 provisional crown after polished, cemented provisional in the mouth and excess removal.

Fig.10

Portemp 4 provisional crown after polished, cemented provisional in the mouth and excess removal.

Zirconia crown of the tooth 21

Fig.11

Zirconia crown of the tooth 21.
Lab credits to Pedro Brito CDT.

zirconia crown paulo monteiro style italiano clinical case

Fig.12

Zirconia crown of the tooth 21.

Internal sandblasting of the Zirconia crown

Fig.13

Internal sandblasting of the Zirconia crown with Cojet (silicatization).

Application of the Scotchbond Universal as ceramic primer

Fig.14

Application of the Scotchbond Universal as ceramic primer in the internal surface of the Zirconia crown.

Application of the Resin Cement in the zirconia crown

Fig.15

Application of the Resin Cement (RelyX Unicem) in the zirconia crown.

Insertion of the zirconia crown in the tooth preparation

Fig.16

Insertion of the zirconia crown in the tooth preparation.

Insertion of the zirconia crown in the tooth preparation

Fig.17

Insertion of the zirconia crown in the tooth preparation and excess of the resin cement.

Resin cement tack curing for 2 seconds

Fig.18

Resin cement tack curing for 2 seconds.

Removing the resin cement excess after the tack curing

Fig.19

Removing the resin cement excess after the tack curing.

Zirconia crown after cementation style italiano clinical case

Fig.20

Zirconia crown after cementation.
We can see the natural integration of the ceramic material with the hard and soft tissues, also due the modeling and adaptation of the provisional crown.

Conclusions

The Bis-acryl resin materials are aesthetic, fast and easy solution to fabricate provisional indirect restorations in the dental office.

BIBLIOGRAPHY

1. Koumjian JH, Holmes JB. Marginal accuracy of provisional restorative materials. J Prosthet Dent.
1990;63:639–42.
2. Holmes JR, Bayne SC, Holland GA, Sulik WD. Considerations in measurement of marginal fit. J
Prosthet Dent. 1989;62:405–8.
3. Balkenhol M, Knapp M, Ferger P, Heun U, Wöstmann B. Correlation between polymerization
shrinkage and marginal fit of temporary crowns. Dent Mater. 2008;24:1575–84.
4. Givens EJ, Jr, Neiva G, Yaman P, Dennison JB. Marginal adaptation and color stability of four
provisional materials. J Prosthodont. 2008;17:97–101.
5. Nejatidanesh F, Lotfi HR, Savabi O. Marginal accuracy of interim restorations fabricated from four
interim autopolymerizing resins. J Prosthet Dent. 2006;95:364.
6. Ellakwa A, Cho N, Lee IB. The effect of resin matrix composition on the polymerization shrinkage and
rheological properties of experimental dental composites. Dent Mater. 2007;23:1229–35.
7. Zortuk M, Bolpaca P, Kilic K, Ozdemir E, Aguloglu S. Effects of Finger Pressure Applied By Dentists
during Cementation of All-Ceramic Crowns. Eur J Dent. 2010;4:383–8.