PROVISIONAL RESTORATION IN FPD ( SEMI 1 ).pptx

provisional restoration in fixed prosthodontics

1. PROVISIONAL RESTORATION OR TEMPORIZATION IN FPD MUGILARASAN MUNISAMY.CRRI DEPARTMENT OF PROTHODONTICS

2. CONTENTS Definition Ideal requirements of provisional restoration Indications Classification of privisional restorations Techniques of fabrication Cementation Conclussion

3. DEFINITION According to the Glossary of prosthodontic terms it can be defined as a transitional restoration that provides protection, stabilization and function before fabrication of the definitive prosthesis. After tooth preparation temporary protective or functional restoration is fabricated over the prepared tooth to be used until fabrication of final prosthesis .

4. IDEAL REQUIREMENTS OF PROVISIONAL RESTORATION BIOLOGIC REQUIREMENTS
MECHANICAL REQUIREMENTS
ESTHETIC REQUIREMENTS

5. BIOLOGICAL REQUIREMENTS Provisional restoration should Protect the pulp because a freshly prepared tooth will have increased sensitivity Maintain periodontal health(good marginal fit) Be occlusally Compatible Protect against fracture

6. MECHANICAL REQUIREMENTS Provisional restoration should Resist functional loads Resist removal forces
Maintain interabutment alignment

7. ESTHETIC REQUIRMENTS Provisional restoration should Be easily contourable Be color compatible
Be translucent
Be color stable

8. INDICATIONS A long span posterior fpd Prolonged treatment time
Patient unable to avoid excessive forces on the prosthesis
Above average masticatory muscle
History of frequent breakage

9. Types of provisional restorations Based on Method of fabrication Materials used According duration of using According to technique of fabrication

10. Method of fabrication Custom made provisional restoration This restoration is fabricated to reproduce the original contours of the tooth An impression of the prepared tooth is made and a cast is poured Prepared tooth on the cast is waxed up
and carved to reproduce the original contours Preformed provisional restorations These are commercially available prefabricated crowns
Available in various sizes
Operator chooses the best one suit to the
patient U Before cementation these crowns are slightly altered and modified to fit the tooth

11. IDEAL REQUIREMENTS OF PROVISIONAL RESTORATION MATERIALS • Adequate strength and wear resistance. • Biocompatibility. • Dimensional stability. • Easy to contour and polish. • Odourless and nonirritating. • Chemically compatible with the luting cements. • Aesthetically acceptable. • Adequate working and setting time. • Easy to repair.

12. Depending upon type of material used Resin based provisional restoration Cellulose acetate
Polycarbonate
Poly-methyl methacrylate
Poly-r methacrylate Microfilled composite
Urethane dimethacrylate Metal provisional restoration Alumnium Nickel titanium Tin silver

13. According to duration of usage Short term temporary restoration(2Weeks ) Long term temporary restoration(few months)

14. According to technique of fabrication Direct technique( intraorally ) Indirect technique( extraorally ) Direct indirect technique(both intra and extraorally )

15. Direct technique

16. Direct technique Step 1- Place acrylic tooth in missing area Step 2 - Take alginate or putty impression Step 3 – Prepare the tooth in patient mouth Step 4- Lubricate the tooth and adjacent gingival regions with petrolium jelly Step 5- Mix and place the temporary material in the impression which is previously taken Step 6- Reseat the impression on the prepared tooth Step 7- Remove and reseat the restoration untill it sets Step 8- Finish , polish and cement the restoration.

17. Indirect technique

18. INDIRECT TECHNIQUE Step 1 – Prepare diagnostic cast , then place and arylic tooth on missing tooth region Step 2 – Make and putty index on the diagnostic cast which should cover the adjacent abutment tooth on both sides Step 3- Prepare the patients tooth as usual manner Step 4 – Make an sectional impression on the prepared tooth and make an check cast Step 5- then apply separating medium on the check cast and mix the temporary restorative material and place on the tissue surface of the putty index. Step 6- after sitting check the fit of temporary restorations on cast and intraorally Step 7 – If thre correction do it then finish, polish and cement the restoration.

19. Direct – Indirect technique

20. Direct – indirect technique Step 1 - Take and impression of unprepared tooth and missing region And pour unprepared diagnostic cast . Step 2- Pace an pontic on missing tooth region and do modifications using the wax for contours , contacts and occlusion Step 3- Lubricate the cast and make and imprrssion using high viscosity elastomeric impression materials Step 4 – Remove the acrylic tooth and prepare the abutment tooth on the doagnoatic cast Step 5 – Apply separating medium on the cast and mix the temporary restorative material and place in index and then reseat on the diagnostic cast.

21. Step 6- After polimarization of temporary restoration , finish it and check the fitting on the diagnostic cast Step 7- then prepare the tooth in the patients mouth asusual manner Step 8- Try the restoration on the patients mouth and make it to fit , then finish, polish and cement the temporary restoration.

22. Recent advances in provisional materials Computer-aided design (CAD)/computer-aided engineering (CAE) aided fabrication using precision-milled acrylate polymer-filled contoured single- and multiple-unit provisional restorations are now available that offer increased strength and fit along with a customizable solution for even the most demanding of patients. The main disadvantage is increased cost.

23. Cementation IDEAL PROPERTIES • Ability to seal against leakage of oral fluid. • Strength consistent with intentional removal. • Low solubility. • Blandness or obtundency . • Chemical compatibility with the provisional polymer. • Convenience of dispensing and mixing. • Ease of eliminating excess. • Adequate working time and short setting time. • Compatibility with the definitive luting agent.

24. Cement used in provisional restoration 1. Zinc oxide eugenol 2. Reinforced zinc oxide eugenol 3. Noneugenol cements.

25. Conclusion SUMMARY Provisional restoration is essential immediately after tooth preparation to prevent the tooth from injury, abnormal tooth movement. It should fulfil the ideal requirements and should be well tolerated and easily accepted by patients. Each provisional restorative material has certain advantages and disadvantages and is selected based on the clinical situation.