1. Provisional Restorations
Wael Al-Omari.
BDS, MDentSci, PhD

2. Functions of Provisional Restorations
 Comfort/tooth vitality
 Occlusion and positional stability
 Function
 Gingival health and contour
 Aesthetics
 Diagnosis
 Other practical uses

3. Assessment of Aesthetic Changes
 Assess appearance of intended
restorations
 Make directly or use a matrix made
from the wax-up.
 Ensure patient’s acceptance
 Record the temporary crowns and
instruct technician to copy their form
ad shape into the final restoration

4. Provisional crown can be used to
assess axial and occlusal reduction

5. Occlusal Changes
 Prevent unwanted tooth movement by maintaining occlusal
and interproximal contacts
 Evaluate patient’s tolerance to change in anterior guidance
or increased occlusal vertical dimension:
 Cement temporary crowns made from diagnostic wax up
and review for aesthetics, guidance, drifting, mobility,
decementation, and comfort
 Copy the provisional crowns guidance by a custom
guidance table, to transfer to definitive restorations.
 It is recommended to assess tolerance to change in vertical
dimension by a reversible method such as splint.

6. Periodontal Changes
 Allow for resolution of inflammation
 Improve gingival healing and stabilization
of gingival margin position
 Used after surgical crown lengthening
during the healing period before definitive
preparation and impression

7. Preoperative Polycarbonate provisional
crown cemented
Gingival healing after 2 months

8. Change in Tooth Shape
 Accurately copy a satisfactory and successful
provisional restoration to:
1. Avoid minor or major changes in tooth shape.
2. Avoid disrupting fine mouth movements and
lip/tooth contact
3. Avoid incorporating wide cervical embrasure to
prevent air leakage

9. Provisional Restorations
Materials
 Preformed crowns
 Plastic shells: polycarbonate or acrylic. Used for
anterior and premolar teeth.
 Metal Shells: aluminum, stainless steel or nickel
chromium.
 Self or light cured resins

10. Aluminum
provisional crown

11. Self or light cured resins
 Polymethyl methacrylate
 Polyethyl methacrylate (Snap, Trim)
 Bis acryl composite (Protemp)
 Urethane dimethacrylate (light cured).
 Restorative composite

12. A- Polymethyl methacrylate
B- Bis-acryl composite

13. Cast Metal
 Nickel chromium, silver and scrap gold.
 Durable
 Can be made with external retention beads to
retain acrylic or composite
 Rarely used

14. Provisional Cements
 Creamy mix of zinc oxide eugenol
 Most practitioners use proprietary cements such as Temp
Bond
 Available with modifier to soften the cement
 Non-eugenol Tem Bond is available and used to:
1. Cement temporary restorations for preparations for
definitive adhesive restorations (eg All ceramic, veneers)
to avoid interference with bonding of resin cements.
 If eugenol containing cement used, eugenol residues
should be removed with pumice and water

15. Provisional Cement (Temp Bond)

16. Direct Provisional Restorations Techniques
 Proprietary Shells
 Plastic Shells: Polycarbonate relined with resin,
trimmed, polished and cemented.
 Metal shells:
1. Aluminum shells: relined with resin (short term).
Soft and galvanize with opposing amalgam
2. Stainless steel and nickel chromium: used with
bruxist patients.
 Custom shells: beaded acrylic and Mill crowns

17. Matrices for Provisional Restorations
 Impressions:
 Alginate: absorbs resin exotherm
 Elastomers: reusable
Advantages: simple, quick, inexpensive.
 Vacuum formed thermoplastic:
 clear vinyl sheet on stone duplicate of the wax up.
 used only in presence of number of adjacent
locating teeth
 could be used with light cured resins.
 Proprietary celluloid crown form

18. A- Alginate impression as a matrix
B- Provisionals with an excess material

19. A preoperative silicone
sectional impression
The resin material in injected
into the impression

20. Techniques
 Direct Syringing: polyethyl methacrylate.
 Indirect Provisionals:
 Used for long term provisionals.
 Strong heat cured materials can be used
 Aesthetics and occlusion made on articulated wax up.
 Indicated or multiple restorations and for an
increased vertical dimension.
 Alginate impression of the preparations, cast in fast
set stone, and fabricate provisionals.

21. A- Stone duplicate of the wax up
B- Vacuum formed matrix

22. A- preparation B-Excess film of material
attached to provisional
crown
C-Trimming the excess D- Cemented provisional
crown

23. Provisionals of Adhesive Restorations
No temporary coverage
 Simple coat of zinc phosphate cement
 Composite resin bonded to a spot
etched on the preparation
 Composite bonded to opposing tooth

24. Problem Solving
 Insufficient bulk of material: Inadequate
reduction, or make it bulkier by relieving the matrix
(impression).
 Gross occlusal errors, air blows and voids: trim
away suspected areas (interpoximal), an educe
hydrostatic pressure by cutting escape vent.
 Locking in of provisional restorations: material
engaging the adjacent tooth proximal undercut.
 Marginal discrepancy: polymerization shrinkage,
distortion on removal, reline with resin around the
margins

25. The inside of the alginate is trimmed
to increase the thickness of the
provisional

26. Problem Solving
 Multiple crowns: joined restorations prevent drifting,
gingival embrasures should be opened to access brushing.
 Premature decementation: Ensure harmony with
occlusion, use stronger cement
 Partial denture abutment: fabricate with the denture fully
seated.
 Eugenol containing cements: do not use if the underlying
core is composite.
 Removing temporary cement: use modifier.
 Removal of excess cement: apply petroleum jelly to
outside of the restorations

27. Pre-operative view
Linked temporary Crowns made
at chairside using preoperative
clear thermoplastic matrix