IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)

e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 18, Issue 4 Ser. 17 (April. 2019), PP 53-58
www.iosrjournals.org

Recent Advances in Provisional Restorations

Dr J Gandhimathi1, Dr M Kanmani2, Dr S Nasreen3, Dr K Vinayagavel4, Dr C
Sabarigirinathan5, Dr L Srinidhi6
1, 2- Assistant professor, TNGDC and hospital, Chennai
4- Professor, TNGDC and hospital, Chennai
5- Professor and HOD, TNGDC and hospital, Chennai
3, 6- PG Students, TNGDC and hospital, Chennai
Corresponding Author: Dr J Gandhimathi

Abstract: Provisional, interim or transitional restoration has been demonstrated to function as an important
component in the majority of the various dental disciplines. Provisional FPDs are the prototype on which
functional, occlusal & aesthetic adjustments are made to optimize the definitive prosthesis. 2
Key words: Provisional restoration, Interim restoration
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Date of Submission: 11-04-2019 Date of acceptance: 26-04-2019
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I. Introduction
A fixed or removable prosthesis, designed to enhance aesthetics, stabilization and /or function for a
limited period of time, after which it is to be replaced by a definitive prosthesis. Often such prosthesis are used
to assist in the determination of the therapeutic effectiveness of a specific treatment plan or the form and
function of the planned for definitive prosthesis.3 Provisional means established for a time being, pending a
permanent arrangement. The term provisional, interim & transitional have been routinely used interchangeably
in the literature.5

Functions of provisional restoration

Provisional restorations are used in the interim between tooth preparation and filling a definitive
restoration. Provisional treatment can also provide an important tool for the psychological management of
patients where a mutual understanding of treatment can be identified.
 Comfort/Tooth vitality: With crown preparation provisional restorations are generally essential to cover
freshly cut dentine and prevent sensitivity, plaque build-up, and subsequent caries and pulp pathology. It
also sedate prepared abutments.
 Occlusion and Positional Stability: To prevent unwanted tooth movement by the maintenance of
interocclusal and proximal contacts. It may be necessary to establish a holding contact on the provisional
restorations.Depending on the patient’s occlusal scheme, the provisional restoration may need to provide
guidance in protrusive and lateral excursions to prevent working and non-working interference.
Interproximal contacts also need to be maintained to prevent food packing.
 Gingival Health and Contour: To facilitate oral hygiene and prevent gingival overgrowth, provisional
restorations require accurate margins and cleansable contour. They can be used in the interim where the
level of the gingival margin had yet to stabilize.
 Aesthetics: To provide adequate interim appearances provisional restorations should either mimic the tooth
just prepared or the final intended restorations.
 Diagnostic Uses: Provisional Restoration especially those used for conventional preparations, are invaluable
in situations where aesthetics, occlusal or periodontal changes to a patient’s dentition are planned. 3
Aesthetic Changes: Proposed changes to the shape of anterior teeth are best tried out with provisional
restorations to ensure patient acceptance and approval from friends and family, clearly it is easier to trim or add
acrylic than it is porcelain. Once happy an alginate is recorded so that the technician can copy the shape into
definitive restoration. It is however important to balance the time spent doing this against the advantages of
having a diagnostic wax up and matrix made in the laboratory.
Occlusal Changes: A patient’s tolerance to changes in anterior guidance or increased occlusal vertical dimension
is best tried out with provisional restorations.

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 Recent Advances in Provisional Restorations

Requirements of Provisional Restoration

The properly fabricated provisional restorations must take into account several interrelated factors,
which can be classified as biologic, mechanical and esthetic. 9
Mechanical
 Resist functional load.
 Resist removal forces
 Maintain interabutment alignment.

Biological
 Protect pulp
 Maintain periodontal health.
 Provide occlusal compatibility.
 Maintain tooth position.
 Protect against fracture.

Aesthetics
 Easily contourable.
 Colour compatibility.
 Translucency.
 Colour stability.

Indications of provisional restorations

 Diagnostic: Prior to making the final restoration it may be advisable to determine the prognosis of the pulps
and the periodontium of the prepared tooth. The dentist can evaluate the occlusal scheme [axial loading and
lateral function], prior to the completion of the final restorations.
 Protective: Cut dentine and associated pulp are protected from salivary, thermal and chemical irritants. The
gingival is also protected when restorations are properly formed.
 Restorative: Replacement of teeth, especially immediate anterior replacements.
 Stabilization or Provisional Splinting: Stabilization is of great importance in the treatment of periodontal
weakened teeth. Amstar dam described this type of temporary restoration as a provisional splint, he
suggested that it will stabilize the weakened teeth and it can be removed to provide access during
periodontal surgery.

TYPES OF PROVISIONAL RESTORATION

Provisional restorations can be classified based on the following methods:
1. Method of fabrication
2. Type of material used.
3. Duration of use
4. Techniques for fabrication.

Depending on Method of Fabrication

a) Custom Made: The restoration is fabricated to reproduce original contours of the tooth. An impression of the
prepared tooth is made and a cast is poured. The prepared tooth on cast is waxed up & carved to reproduce the
original contours.
Advantage:
• Minimum interference
• A wide variety of materials can be used.
• Helpful in evaluating the adequacy of tooth reduction. By measuring the thinness of restoration, the tooth
preparation can be altered.

Disadvantage:
• Additional lab procedure involved.
• Time consuming.

b) Preformed Provisional Restoration: - Preformed crowns are commercially available prefabricated crowns.
These crowns are available in various sizes. The operator can choose the size and material that would best suit
the patient.

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 Recent Advances in Provisional Restorations

Advantage:
• Less time consuming.
Disadvantage:
• Rarely satisfies the requirement of contours. It has to customize with self-cure resin.
• Generally limited to single tooth restoration.

II) Depending on the Type of Material Used101

A) Resin based Provisional Restoration

The various resin-based materials used to make provisional restorations are:
• Cellulose acetate
• Polycarbonate
• Polymethyl methacrylate: chemically activated resin.
• Poly-R-methacrylate: R group could be ethyl or isobutyl form of resin.
• Micro-filled Composite: BISGMA
• Urethane di-methyl acrylate: light-cured resins

B) Metal Provisional Restoration

Metal provisional restorations are usually fabricated using:
• Aluminum
• Nickel – Chromium
• Tin –Silver

III) Depending On Technique of Fabrication101

Based on Technique of fabrication, provisional restorations can be classified:
a) Provisional Restorations fabricated using direct technique
b) Provisional Restorations fabricated using indirect technique.
c) Provisional Restorations fabricated using direct – indirect technique.

IV) Depending On Duration of Use6

Based on the duration for which restoration is intended to be used, provisional restorations can be classified:
a) Short term provisional, for use up to 2 weeks
b) Long term provisional, for use from 2 weeks to a few weeks
A) Short Term Provisional Restoration
• These are used when prosthesis is to be used for a maximum for 2 weeks.
• They are indicated after tooth preparation in FPDs.
• They are either custom made resin or available as preformed crowns.
• Polycarbonate or aluminum crowns are the most commonly used Short-term provisional restoration

B) Long Term Provisional Restoration

They are mainly made of cast metal. Though their strength is more than average, they have history of
frequent breakage.
Limitations of temporisation
1) Lack of Inherent Strength: - Temporaries fracture in long span coverage in patients with bruxism habits or a
reduced interocclusal clearance, if the bulk is increased, the patients discomfort is evident.
2) Poor Marginal Adaptation: - This inherent deficiency is difficult to improve upon. Temporization infers
“adequate” at best.
3) Colour Instability: -This is apparent when temporary restorations are placed for an inordinate time.
4) Poor Wear Properties: - Teeth will drift or torque if the patient places heavy occlusal stresses upon the interim
coverage.
5) Detectable Odour Emission: - This is undeniable despite the dentists close attention to sufficient embrasure
spaces. Resins are porous.
6) Inadequate Bonding Characteristics: - Few types of cement currently secure an adequate interface
relationship with resins. Eugenol – bearing sedative cements are notorious for incompatibility with methyl
methacrylate resins.
7) Poor Tissue Response to Irritation: - Mild or moderate tissue irritations is always present. Certain techniques
are merely less irritating than other techniques.

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 Recent Advances in Provisional Restorations

II. Conclusion
Interim restorations are a critical component of fixed prosthodontic treatment. In addition to their
biologic and biomechanical requirements, interim restorations provide the clinician with valuable diagnostic
information. They act as a functional and aesthetic try-in and serve as a blue-print for the design of the definitive
prosthesis.
Although provisional restorations are usually intended for a short period of time and then discarded,
they can be made to provide pleasing aesthetics, adequate support, and good protection for the teeth.

Silver crowns

Nickel-Chromium crown

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 Recent Advances in Provisional Restorations

Polycarbonate crowns

Cellulose Acetate crown

Custom made restoration

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 Recent Advances in Provisional Restorations

References
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[2]. Adams WK. A temporary fixed partial denture. J Prosthet Dent 1970;24;571-2.
[3]. Appleby DC, Doukoudakis, Doukoudakis A. Improved occlusal surface detail with the vacuum-formed matrix. J Prosthet Dent
1994;72:113.
[4]. Aparicio C. A new method for achieving passive fit for an interim restoration supported by Branemark implant: A technical note.
Int J Oral Maxillofac Implant 1995;10:614-8.
[5]. Alfred J. Soletra. A direct technique for fabricating acrylic resin temporary crowns using the Omnivac. J Prosthet Dent
1973;29:577-560.
[6]. Assif D, Himmel R. A technique for improving the marginal fit of temporary acrylic resins crown using injection of self-curing
acrylic resin. Quintessence International 1986;17:313-315.
[7]. Amin AE. The effect of poly-aramidefiber reinforcement on the transverse strength of a provisional crown and bridge resin. Egypt
Dent J 1995;41:1299-304.
[8]. 8. Amsterdam M. Provisional splinting. Principles and techniques. Dent Clin North Am 1959;73-9.
[9]. Amet EM, Phinney TL. Fixed provisional restorations for extended prosth¬odontic treatment. J Oral Implantol 1995;21 :201-6.
[10]. Antonoff SJ, Levine Hy. Fabrication on acrylic resin temporary fixed prosthesis for an allergic patient. J Prosthet Dent
1981;45:678-9.

Dr J Gandhimathi. “Recent Advances in Provisional Restorations.” IOSR Journal of Dental

and Medical Sciences (IOSR-JDMS), vol. 18, no. 04, 2019, pp 53-58.

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