TEMPORIZATION IN PROSTHODONTICS

From Exam Point

2. Dr.PrakashNidawani
Professor,
DepartmentofProsthodontics,
NavodayaDentalCollege.
Temporary Before Permanent –Provisional
Restoration & Cementation

3. DEFINITION
A fixed or removal prosthesis designed to enhance esthetics ,
stabilization and function for a limited period of time after
which it is to be replaced by definitive prosthesis.
(GPT –9)
SYNONYMS
Temporization
Interim prosthesis
Provisional prosthesis
[provisional –established for time being]
Dr. Nidawani

4. Rationale for provisional treatment
(Fredrick and Krug)
1.Provide method for immediately replacing missing teeth.
2.Protect prepared abutments from thermal, chemical, mechanical
and bacterial insults.
3.Protect soft tissues –gingiva, tongue, lips & cheek.
4.Provide comfort function and Improve esthetics.
5.Prevent migration of abutments.
6.Evaluate and reinforce the patient’s oral home care
Dr.Nidawani

5. 7. Provide a matrix for the retention of periodontal surgical dressings.
8. Stabilize mobile teeth during periodontal therapy and evaluation.
9. Provide anchorage for orthodontic brackets during tooth movement
10. Aids in developing and evaluating an occlusal scheme before
definitive treatment.
11. Allow evaluation of vertical dimension, phonetics & masticatory
function.
12. Assist in determining the prognosis of questionable abutments
during prosthodontic treatment planning.
J Prosthet Dent 2003;90:474-97
Dr.Nidawani

6. DESIRABLE PROPERTIES
•Biocompatibility
•Pleasing esthetics
•Dimensional stability
•Ease of fabrication
•Fracture resistance
•Non porous
•Contourable
Dr.Nidawani

7. IDEAL REQUIREMENTS OF PROVISIONAL
RESTORATION
THREE BASIC REQUIREMENTS:
Biologic requirements
Mechanical
requirements
Esthetic
requirements
Dr.Nidawani

8. BIOLOGIC
Pulp protection
Periodontal health
Occlusal compatibility
Tooth position
Protect against fracture
ESTHETIC
Contourable
Colour stability
Translucent
Texture
MECHANICAL
Resist Functional load
Resist Removal forces
Maintain inter
abtment alignment
Rosensteil , Land ,Fujimoto –CFP -4
THED
Dr.Nidawani

9. BIOLOGIC REQUIREMENTS
PULP PROTECTION:
Dentinal tubules exposed –during tooth preparation.
Provisional restoration –should protect the prepared tooth from oral
environment, thereby preventing sensitivity and irritation to pulp.
PERIODONTAL HEALTH:
It should have good marginal fit, proper contour & smooth surface to
prevent accumulation of food debris & facilitate easy plaque removal.
Dr.Nidawani

10. POSITIONAL STABILITY:
It should provide comfortable & stable functional occlusal relationship
by maintaining interarch and intra-arch stability thereby preventing
tooth migration and supra eruption.
PREVENTION OF FRACTURE:
It should protect the prepared tooth surface from fracture.
In partial coverage restoration, in which margin of preparation is close
to occlusal surface of tooth can be damaged during mastication.
Dr.Nidawani

11. MECHANICAL REQUIREMENTS
FUNCTIONAL:
It should possess good compressive & flexural
strength.
The greatest stresses in provisional restoration
occurs during chewing.
RETENTION:
It should have close adaptation to the prepared
tooth surface to prevent displacement & recementation.
RESISTS REMOVAL FORCES
Be strong enough for repeated removal and recementation.
Dr.Nidawani

12. ESTHETIC REQUIREMENTS
It should match the size, colour, shape and texture of the
restored tooth especially in anterior region.
Colour stability is also important if the provisional restoration
are to function for a prolonged period.
Serves as a guide to achieve esthetics to the final restoration.
Dr.Nidawani

13. PROVISION
AL
RESTOTATI
ON
METHOD OF
FABRICATION
CUSTOM
MADE
PRE
FABRICATED
POLYCARBONATE
CELLULOSE
ACETATE
ALUMINIUM AND
TIN-SILVER
NICKEL-
CHROMIUM
TYPE OF MATERIAL
USED
RESINBASED
PROVISIONAL
RESTORATION
METALBASED
TECHNIQUE OF
FABRICATION
DIRECTTECHNIQUE
IN-DIRECT
TECHNIQUE
IN-DIRECT --DIRECT
TECHNIQUE
CAD –CAM
TECHNIQUE Dr.Nidawani

14. TYPES OF
PROVISIONAL
RESTORATIONS

15. I.DEPENDINGONMETHODOFFABRICATION:
1.CUSTOMTEMPORARIES:
Madewithamatrixderivedfromoriginaltoothora
modifieddiagnosticcastorbycad/cam.
Advantage:
•Minimalinterference.
•Widevarietyofmaterialscanbeused.
•Helpfulinevaluatingtheadequacyoftoothreduction.
Disadvantage:
•Additionallabprocedureinvolved.
•Timeconsuming.
Dr.Nidawani

16. 2-PREFABRICATED TEMPORARIES
These are preformed crowns that may be modified to fit a
prepared tooth.
In most cases these requires relining with an acrylic material.
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
IOSR Journal of Dental & Medical Sciences vol18(4) 2019
Dr.Nidawani

17. II. DEPENDING UPON THE TYPE OF MATERIAL USED
A)Resin based Provisional Restoration
-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
-Aluminum
-Nickel –Chromium
-Tin –Silver
IOSR Journal of Dental & Medical Sciences 2019 vol18(4)
Dr.Nidawani

18. ACRYLICRESINS:(Methylmethacrylate,EthylmethacrylateorVinyl
methacrylate)-SNAP,DPI,Trantemp,Biolon,BosworthTrimII.
Oneoftheoldestmaterialavailableaspowder&liquid.
Advantages:
•Goodwearresistance&availableinmanyshades.
•Capableofhighpolish&lessexpensive.
Disadvantages:
•Significantamountofheatgivenoffbyexothermicreaction.
•Highdegreeofshrinkage(about8%).
•Pungentodor.
Dr.Nidawani

19. Donovan TE, Hurst RG & Campagni WV. Physical properties of
acrylic resin polymerized by four different techniques. J. Prosthet.
Dent. 1987;54:194-97determined autopolymerizing polymethyl
methacrylate resin specimens polymerized with pressure
demonstrate increase transverse strength and less porosity.
Polymerization under water have no effect on physical properties.
T. Nigel Town, M.A et al Provisional Restorations : An Overview of
material used. Journal of Advanced clinical & Research Insights
2016;3:212-14.
In cases of full mouth rehabilitation cases and cases involving
more than 5 unit bridges, Heat cure PMMA are more superior in
prolonged use temporary with better physical and mechanical
properties Dr.Nidawani

20. BIS –ACRYL MATERIALS (20 years old)
Bis-acrylics are multi functional dimethacrylate materials capable
of cross-linking.
Can be categorized into two groups: UDMA and bisphenol A-
glycidyl methacrylate (Bis-GMA).
Less heat generation and shrinkage ,water sorption, minimal
odour.
Faster setting time, better mechanical properties –so fabricated
more efficiently with greater predictability.
Dr.Nidawani

21. VISIBLE LIGHT CURED RESINS : (sets on command )
Based on UDMA (urethane di-methacrylate).
Has good mechanical properties & color stability.
Available in variety of shades.
Marginal fit is good as there is less
polymerization shrinkage.
Operator has the advantage over control
of the working time as it is light cured.
Expensive and stains overtime.
Dr.Nidawani

22. Luxatemp®, (DMG America, www.dmgamerica.com)
high filled self and light cured,glass filler of 44wt%
Luxatemp Fluorescence ; Aimed at achieving superior esthetic.
Luxatemp Ultra ; which incorporates proprietary nano technology
to provide increased flexural strength.
Luxatemp Solar ; a light-cured material.
Comp strength 250 Mpa -making it an ideal choice for long-span
temporary bridges.
LuxaFlow™ for-repair & reline.
Luxa glaze varnish that provides a surface glaze for provisionals.
Dr.Nidawani

23. Protemp™ (3M ESPE, www.3MESPE.com)2,3,4, line of bis-acryl
provisional material with “a new generation of sophisticated
nanotechnology fillers”.
Protemp Plus -highly fracture-resistant material in five shades
with high gloss without polishing.
3M ESPE Filtek™ Supreme Ultra Flowable reline & repair material
Sheen -using an alcohol gauze to wipe the provisional restoration
with ethanol
Dr.Nidawani

24. Astudillo-Rubio D, Delgado-Gaete A, Bellot-Arcı ´s C, Montiel-
Company JM, PascualMoscardo ´A, Almerich-Silla JM .Mechanical
properties of provisional dentalmaterials: A systematic review and
meta-analysis. PLoS ONE .2018;13(2): e0193162
Dimethacrylate based (Bis -acrylics) provisionals presented better
mechanical behavior than monomethacrylate for flexural strength
and hardness. Fracture toughness showed no significant differences.
Within the monomethacrylate (acrylics) group, polymethyl
methacrylate showed greater flexural strength than polyethyl
methacrylate.
Dr.Nidawani

25. Protemp line is the Protemp Crown Temporization Material.
Preformed, malleable composite temporary crowns with nine
preformed sizes, custom fit for single-unit crowns that provide
remarkable strength -with compressive strength of 395.6 MPa
Integrity® Multi-Cure, (DENTSPLY Caulk) is reported by the
manufacturer to deliver durable results due to wear resistance
and strength properties (compressive strength of 386 MPa to 394
MPa) light-cured for 20 second
Inspire™ (Clinician’s Choice, www.clinicianschoice.com) lowest
exothermic reactions, coming in at 53°
Dr.Nidawani

26. Perfectemp 10 (DenMat, www.denmat.com); Elastic modulus is
reported at 3500 MPa, flexural strength 120 MPa, less than
3.4%.volumetric shrinkage. The Structur® (VOCO America, Inc.,
www.voco.com)
Structur 3 ; Nanofilled material with high fracture resistance and
compressive strength (more then 500 MPa), wipe and go
technology
Structur Premium ;1:1 cartridge mix , fast setting Bis-acryl
provisional material with ceramic-like esthetics, high fracture
resistance ideal for long-span bridges, a brilliant gloss, natural
fluorescence, .
Dr.Nidawani

27. Visalys® Temp; (Kettenbach, www.kettenbach.us) high
fracture-resistant material (impact strength 12.5 KJ/mm²,
flexural strength 132 MPa), can be precisely trimmed with
minimal dust and has a high luster.
Tuff-Temp™ Plus; (Pulpdent Corp., www.pulpdent.com)
features a synthetic rubber molecule inserted into it to produce
a tough, impact-resistant, dimensionally stable provisional
material that the manufacturer calls a “rubberized urethane”.
Dr.Nidawani

28. REINFORCEMENTOFPROVISIONALRESTORATIONS
Reinforcement of the provisional restoration is recommended in long
span/long term,
•Periodontallycompromisedabutments.
•Restorationoflostverticaldimension.
•Restoringlongspanbridges.
•Caseswithabnormalocclusalforces/habits,
•Repeatedfractureofrestoration.
•Acidetchedbridges/resinbondedprosthesis.
Dr.Nidawani

29. Reinforced provisionals maintain better occlusal stability, flex less
there by minimizes progressive cement loss and diminished caries
incidence.
Fibersaddedtoheatcured,selfcured&lightcuredmaterials:nylon
fibers,graphitefibers,carbonfibers,polyesterfibers,ultrahigh
molecularweightpolyethylenefibersandglassfibers.
Preimpregnatedfibers:polymermonomermixforACRYLICS,
bondingagentforBIS-GMAenhanceadhesionbetweenfiber&
matrix.
Others:Swagemetalsubstructure,16-18gaugemetalcastframe
work,stainlesssteelwire,orthobands.
.
Dr.Nidawani

30. Reinforcingfibers:
•Earlierthecarbonfiberswereusedwhichwereunestheticand
therewasnochemicalbondingtotheresin.
•Therewerealsochancesoffrayingofthefibers,whichwere
exposedonthesurface.
•Recently,thenylonfiberswereintroducedinwhichtherewasno
chemicalbondingwithpolymerssonosignificantincreasein
strength.
Dr.Nidawani

31. Polyethylenefibers(CapaccioandWard,1973):
•Veryhighmolecularweightandthusimproves
strength(transverseandflexuralstrength).
•Noproperwettingoffibersbypolymer-needsconditioning.
Chemicalconditioningdonebyetching,plasmatreating,heattreatment
andsilanizingthefibers.
Glassfibers(P.K.Vallittu,1998):
•Availableaswovenfibersandunidirectionalfibers.
•Reinforcementofponticandconnector(bridge)-unidirectionalfibers
Crown–Wovenfibers
Dr.Nidawani

32. CAD –CAM MILLED RESIN BLOCKS :
Superior marginal fit –lowers the risk of bacterial
contamination of the tooth and prevents damage to pulp from
excessive temperature changes.
Stronger and more accurate (industrial polymerized).
Good mechanical properties.
Serves as a solution for long-term/long-span interim prosthesis
where strength and colour stability is required.
Easy to manipulate.
Dr.Nidawani

33. Ishita Dureja et al .A comparative evaluation of vertical marginal fit
of provisional crowns fabricated by computer aided design/
computer aided manufacturing technique & direct (intra oral tech)
& flexural strength of the materials : An in vitro study. JIPS 2018
Concluded that Bis –aryl composite resin based
autopolymerizing Protemp™ 4( 101.41 MPa) and CAD/CAM
(94.06 Mpa) provisional materials have comparable flexural
strength. However, the marginal fit of temporary crowns
fabricated by CAD/CAM was found to be superior (34.34 µm) to
the ones fabricated with Protemp™ 4. (63.42 µm).
Dr.Nidawani

34. III. DEPENDING UPON THE TECHNIQUE OF FABRICATION:
a) Provisional Restorations fabricated using direct technique :these are
constructed with a matrix lined with provisional material that is
placed directly on the preparedtooth
b) Provisional Restorations fabricated using indirect technique :
constructed by placing the filled matrix over a model of the prepared
tooth, thus the provisional is constructed out of the patient'smouth
c) Provisional Restorations fabricated using direct –indirect technique
made by forming a temporary in an indirect manner on mock
prepared model and then relined directly in patients mouth.
This method is useful in constructing temporary bridges.
IOSR Journal of Dental & Medical Sciences vol18(4) 2019
Dr.Nidawani

35. DIRECT VS INDIRECT VS DIRECT INDIRECT
Direct -faster for routine provisional restorations.
Indirect can save time with multiple units or complex
fixed partial dentures.
Indirect-direct provisionals can be fabricated in
advance of the tooth preparation appointment.
Dr.Nidawani

36. IV. DEPENDING ON DURATION OF USE:
a) Short term provisional, for use up to 2 weeks
Indicated after tooth preparation in FPDs.
Custom made using acrylics or composite based materials.
Relined polycarbonate or aluminum preformed crowns .
b) Long term provisional, for use from 2 weeks to a few months
Full mouth rehabilitation.
In patients undergoing orthodontic, endodontic, periodontic,
implant treatment, in presence of deciduous teeth.
Benefits vs value decisions in medically compromised elderly .
IOSR Journal of Dental & Medical Sciences vol18(4) 2019
Dr.Nidawani

37. EXTERNAL SURFACE FORM
The external contour of the crown is known
as External Surface Form (ESF).
There are two categories : Custom
Preformed
CUSTOM
A custom is a negative reproduction of either the patient’s
teeth before preparation or a modified diagnostic cast.
PREFORMED
Various preformed crowns are available commercially.
Dr.Nidawani

38. INTERNAL SURFACE FORM (ISF)
Prepared tooth surface is known as Internal Surface
Form.
It can be obtained by three methods
1.Direct
2.Indirect
3.Indirect -Direct
Dr.Nidawani

39. DIRECT
TECHNIQUE

40. Types Of Templates :
Putty index made on cast or intra orally
using atray
Clear plastic vacuum-formed template
Combination of thermoplastic & translucent impression
material.Ioannis Konstantinidis; (J Prosthet Dent 2013;109:198-
201)
Dr.Nidawani

41. Techniques describedall of the literature on direct
provisionalrestorations:
Use of a pre manufactured provisionalsheIl& relining.
Use of an impression material, or pressure or vacuum formed
translucent matrix& relining.
Use of thermoplastic material and translucent polyvinyl siloxane-
menosil 2 (heracus Kulzer , Germany) & relining.
Temporary temporary-Goldstein created immediate interim
direct temporary by using vaccum formed matrix on wax up
stone model and filling it with tooth colored c-silicon(GC Fit
checker)
Dr.Nidawani

42. DIRECT TECHNIQUE
Patient’s prepared teeth and the gingival tissues directly provide
the internal surface form.
Eliminates all intermediate laboratory procedures.
Disadvantage:
Potential tissue & pulp trauma from exposed dentinal tubules
from the exothermic heat of polymerizing resin.
Formation of voids.
Inherently poorer marginal fit.
Therefore, directly formed interim restoration limited for single
crowns, indirect techniques for multiple units.
Dr.Nidawani

43. RELINED ALUMINIUM SHELLS RELINED POLYCARBOXYLATE CROWN
VACCUM FORMED TEMPLATE
PUTTY TEMPLATE
Dr.Nidawani

44. Acrylictoothisplacedintheareaofmissingtooth.
Alginateimpressionoraputtyindexismade.
Patient’steethisprepared&lubricatedwithpetroleumjelly
(includingadjacenttooth&gingivalmargins).
Indexoralginateimpressionisreseatedwithprovisional
restorativematerial(doughstage).
Removeandreseatfollowedbyfinishing,polishing&cementation
Dr.Nidawani

45. Dr.Nidawani

46. Alternative Techniques for Direct Technique
Acrylic Resin Block Technique for Direct Provisional Restoration:
Aseldomemployed,method.
It provides a means of fabricating the interim restoration
without the use of diagnostic casts and laboratory processing
costs.
The technique requires knowledge of dental anatomy, patience
and artistic traits inherent in dentists.
Dr.Nidawani

47. INDIRECT TECHNIQUE

48. Involves fabrication of the interim restoration outside the mouth.
MERITS:
No contact of free monomer with the prepared teeth or gingiva which
might cause tissue damage & allergic reaction or sensitization.
Avoids subjecting prepared tooth to heat evolved from polymerizing
resin.
Superior marginal fit.
Frees the patient & dentist for considerable amount of time. (fabricated
in lab)
DEMERITS :
Increased time & number of intermediate steps.
Inadequacy of assistants or the laboratory facilities.
Possible damage of diagnostic casts.
Dr.Nidawani

49. PROCEDURE:
Acrylic tooth placed on missing tooth area of diagnostic cast & putty
index is made
Sectional impression made on diagnostic cast
Provisional restorative material is injected into putty index
Fit is checked on the diagnostic cast
Restoration is relined for proper marginal fit
Finishing, Polishing followed by Cementation.
Dr.Nidawani

50. Dr.Nidawani

51. DIRECT –INDIRECT
TECHNIQUE

52. This technique produces
-custom made preformed external surface form of the restoration
-internal tissue surface form is formed by underprepared diagnostic casts.
Advantages:
Reduced chair time (provisional shell is fabricated before patient’s appointment)
A smaller amount of acrylic resin will polymerize in contact with the prepared
abutment, resulting in decreased heat generation, chemical exposure, and
polymerization shrinkage compared to the direct technique.
Contact between resin monomer and soft tissues is reduced and less chances of
allergic reactions.
Disadvantage:
Potential need of a laboratory phase before tooth preparation
Adjustments that are frequently needed to seat the shell completely on the
prepared tooth.
Dr.Nidawani

53. PROCEDURE:
Pontic is placed in the area of missing in diagnostic cast & putty
index is made with suitable material
Acrylic tooth is removed & abutments are preparedon the
diagnostic cast (Preparations should be more conservative than the eventual
tooth preparation and should follow precisely the gingival margins.)
Diagnostic cast is lubricated with suitable separating media &
provisional restorative material is filled into putty index & reseated
Provisional restoration must be paper thin & correctly contoured
Dr.Nidawani

54. Patient’s teeth is prepared in usual manner.
Preformed restoration is tried in patient’s mouth (If the amount of
tooth reduction is adequate, the provisional restoration will show optimal
marginal fit with no need for adjustment.)
Temporary restoration is relined to perfect the internal fit.
Finishing, polishing and cementation.
Dr.Nidawani

55. Dr.Nidawani

56. Provisional restoration for post & core restorations
If custom made post and core is to be used, it can be instantly
built and temporary crown be fabricated on it.
For cast posts, following measures may be taken.
(a) A ball pin/wooden wedge placed into the post space and an
alginate over impression made that would pick up the ball pin
and then the restoration fabricated on the cast.
(b) In an alternative technique, a ball pin may be placed into
the post space and the restoration fabricated intra orally using
acrylic resin block technique.
A tooth trimmed in the form of a labial veneer can also be used to
serve the purpose.
Dr.Nidawani

57. IMPLANTSUPPORTEDPROVISIONALRESTORATIONS:
Provisionalprosthesisdesignsfordentalimplantpatients
canvarywidely,rangingfromaremovableacrylicresin
complete/partialdenturerelinedwithsoftlinertoanimplant
supportedfixedprosthesis.Severaldifferentpotentialdesignsthat
promoteesthetics,convenience,theloadingofimplants,tissue
contourcontrol,materialstrength,andinterimprosthesis
durability.
Dr.Nidawani

58. Provisionalfixedprosthodontictreatmentoptionsforan
implantpatientthatmayvarydependingonthefollowing:
•Thenumber,position,orlocationoftheimplants.
•Thenumberofnaturalteethremaininginatreatmentarch.
•Opposingocclusion.
•Whetherteethadjacenttotheimplantsite(s)canserveas
abutmentteethforaprovisionalrestoration.
•The desired protocol for provisional treatment at either first or
second stage surgery.
Dr.Nidawani

59. PROVISIONAL LUTING MATERIALS:
Provisional luting agents should possess :
-good mechanical properties.
-low solubility.
-tooth adhesion to resist bacterial & molecular
penetration.
Provide an adequate seal & Sedative effects that reduces dentin
hypersensitivity.
Strong enough to retain a provisional restoration during the
course of treatment but, allow easy restoration removal when
required.
Dr.Nidawani

60. There are a variety of luting materials used for interim
purposes. The most common include:
(1)Calcium hydroxide
(2)Zinc-oxide eugenol
(3)Non-eugenol materials.
Zinc phosphate, Zinc polycarboxylate & GIC –not used.
Because of their comparatively high strength which makes
intentional removal difficult.
Dr.Nidawani

61. ZincOxideEugenolCement:
Itisoneofthemostcommonlyusedcosteffectivetemporary
lutingcement.Becauseofeugenolitprovidesanobtundenteffect
andantimicrobialeffect.Ithasadequatestrength.Easeofremoval
0frestoration.
Disadvantages:
Eugenol –interfere with polymerization of resin.
Dr.Nidawani

62. Free radical production necessary forpolymerization of
methacrylate materials can be significantly hampered by the
presence of eugenol, thisinterference with the acrylic /resin
polymerization and hardening processand softens restoration.
Eugenol interferes with polymerization of resin cements that are
used to fix final restoration.
Eugenol used in cementation of temporary restoration can
penetrate into dentine and might affect adhesion of resin
cements.
Dr.Nidawani

63. Therefore eugenol free provisional luting materials containing
essential oils are commercially available and have gained
popularity.
Dr.Nidawani

64. CementRemnantsandTheirEffectonPermanentLuting:
ElisiteKarunkietal(2000)gaveamethodtoenhancethebond
strengthofthepermanentcementsfollowingtheremovalofthe
temporaryrestoration.Afterremovalofcements,thetoothpreparation
wasconditionedwith38%phosphoricacidand10%NaOCI.Bond
strengthwasbetterafterconditioningwithH
3
PO
4
andNaOCI.
MicroleakageandTemporaryCements:
PalaoBetal(1998)conductedastudytocheckthemicroleakage
anddiepenetrationbetweentoothpreparationandthecementand
reportedthatthemicroleakagewasseeninallcements.LessinCa
(OH)
2
andzincphosphatecementandmoreforzincoxideandnon-
eugenolcement.
Dr.Nidawani

65. Dr.Nidawani

66. Dr.Nidawani

67. REMOVAL OF PROVISIONAL
RESTORATION

68. Theprovisionalisremovedwhenthepatientreturnsforthe
definitiverestorationorforcontinuedpreparation.
Riskofdamagetothepreparedtoothcanbeminimizedif
removalforcesaredirectedparalleltothelongaxisofthe
preparation.
TheBackhansorhemostaticforcepsareeffective.
Holdinglukewarmwaterinmouthsoftenslutingcement.
Sometimesitishelpfultoloopdentalflossundertheconnector
ateachendoftheFPD,providingamoreevenforce
distributionforremoval.
Dr.Nidawani

69. LIMITATIONS OF TEMPORIZATION :
i) Lack of Inherent Strength: -fractures in long span coverage in
patients with bruxism or a reduced interocclusal clearance, if
the bulk is increased, the patients discomfort is evident.
ii) Poor Marginal Adaptation:
iii) Colour Instability: -This is apparent when temporary
restorations are placed for an inordinate time.
iv) Poor Wear Properties: -Teeth will drift or torque if the patient
places heavy occlusal stresses upon the interim coverage.
Dr.Nidawani

70. v) Detectable Odour Emission: -This is undeniable despite the
dentists close attention to sufficient embrasure spaces. Resins
are porous.
vi) 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.
vii) Poor Tissue Response to Irritation: -Mild or moderate tissue
irritations is always present.
IOSR Journal of Dental & Medical Sciences 2019 vol18(4)
Dr.Nidawani

71. CONCLUSION:
Successful temporary restorations are pillars for
successful final restorations.
Dr.Nidawani

72. REFERENCES:
STEPHENFROSENSTIEL.ContemporaryFixedProsthodontics.
HERBERTTSHILLINGBERG.FundamentalsofFixedProsthodontics.
TYLAMAN.TheoryandpracticeofCrownandBridgeProsthodontics.
Rationaleofprovisionalrestoration-JProsthetDent2003;90:474-97.
Typesofprovisionalrestoration-IOSRJournalofDental&Medical
Sciences2019vol18(4)
DonovanTE,HurstRG&CampagniWV.Physicalpropertiesofacrylic
resinpolymerizedbyfourdifferenttechniques.J.Prosthet.Dent.
1987;54:194-97
T.NigelTown,M.AetalProvisionalRestorations:AnOverviewofmaterial
used.JournalofAdvancedclinical&ResearchInsights2016;3:212-14
Dr.Nidawani

73. Astudillo-Rubio et al.Mechanical properties of provisional dentalmaterials:
A systematic review and meta-analysis.PLoS ONE .2018;13(2): e0193162
Ishita Dureja et al .A comparative evaluation of vertical marginal fit of
provisional crowns fabricated by computer aided design/ computer aided
manufacturing technique & direct (intra oral tech) & flexural strength of the
materials : An in vitro study. JIPS 2018
K.M.Regish, Deeksha Sharma & D.R.Prithviraj. Techniques of Fabrication of
Provisional Restoration: An Overview.International Journal of Dentistry
Volume 2011
Limitations of temporization -IOSR Journal of Dental & Medical Sciences
2019 vol18(4)
Baldissara P Comin G, Martone F, Scotti R. Comparative study of the marginal
microleakage of six cements in fixed provisional crowns. J Prosthet Dent
1998;80:417-22.
Dr.Nidawani

74. QUESTIONS ASKED

75. RGUHS
1.Luting agents in provisional restoration (Sep 2007)
2.Temporization & its importance (Sep 2007)
3.Provisional Restoration (May 2010, July 2016)
4.Explain the methods of Temporization (Nov 2011)
5.Temporization in FPD (May 2014, May 2019)
6.Rationale for Provisional Restorations (Nov 2016)
Dr.Nidawani

76. OTHER UNIVERSITIES
1.Techniques of fabrication of provisional restoration (oct
2019)
2.Discuss provisionalization in FPD (2013)
3.Provisional restorations (June 2016, 2017)
4.Utility & Scope of temporization in Fixed Prosthodontics
(2017)
5.Write a note on temporization (2005)
Dr.Nidawani