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Introduction to Fixed Prosthodontics

Introduction to Fixed Prosthodontics
Forth Year

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    Provisional restoration Provisional restoration Presentation Transcript

    • Definition A fixed prosthesis, designed to enhance Esthetics, stabilization and/or function for a limited period of time, after which it is to be replaced by a definitive prosthesis. Often such prostheses are used to assist in determination of the therapeutic effectiveness of a specific treatment plan or the form and function of the planned for definitive prosthesis
    • Requirements of Provisional Restoration I. Biologic requirement II. Mechanical requirement III. Esthetic requirement
    • Requirements of Provisional Restoration I. Biologic requirement: • • • • • Protect the dental pulp Maintain and contribute to the periodontal health Provide comfortable, functional occlusal relationship Maintain tooth position Protect remaining tooth structure
    • After 1 week After 2 months
    • Requirements of Provisional Restoration II. Mechanical requirement: – – Resist functional load Resist removal forces without fracturing
    • Requirements of Provisional Restoration III. Esthetic requirement: – – Resemble natural teeth Color stability
    • Types of Provisional Restoration I. II. Preformed custom crown shells Customized resin restorations 1. Direct technique a. Direct matrix-assisted • • b. 2. 3. Elastomeric or alginate impression Vacuum formed plastic template Direct custom-carved (block-temporary) Indirect technique Indirect-direct (combination) technique
    • Types of Provisional Restoration I. Preformed custom crown shells • • Cellulose acetate crown forms Polycarbonate crown forms • Anatomic metal crowns • Acrylic resin shells
    • Types of Provisional Restoration I. II. Preformed custom crown shells Customized resin restorations 1. Direct technique a. Direct matrix-assisted • • b. 2. 3. Elastomeric or alginate impression Vacuum formed plastic template Direct custom-carved (block-temporary) Indirect technique Indirect-direct (combination) technique
    • Types of Provisional Restoration II. Customized resin restorations 1. Direct technique • • Initial polymerization occurs intraorally Final polymerization occurs extraorally
    • Types of Provisional Restoration II. Customized resin restorations 1. Direct technique a. Direct matrix-assisted • • Elastomeric or alginate impression Vacuum formed plastic template
    • Types of Provisional Restoration I. II. Preformed custom crown shells Customized resin restorations 1. Direct technique a. Direct matrix-assisted • • b. 2. 3. Elastomeric or alginate impression Vacuum formed plastic template Direct custom-carved (block-temporary) Indirect technique Indirect-direct (combination) technique
    • Types of Provisional Restoration II. Customized resin restorations 1. Direct technique b. Direct custom-carved (block-temporary)
    • Types of Provisional Restoration II. Customized resin restorations 1. Direct technique Disadvantages: • • • • Adverse pulpal or soft tissue reaction to monomer and increased temperature Allergic reaction Locking of restoration into undercuts Consuming chair time
    • Types of Provisional Restoration II. Customized resin restorations 1. Direct technique Avoiding potential problems • • • • Remove provisional restoration from teeth while in plastic stage Allow final polymerization to occur extraorally Use water coolant Use reline technique
    • Types of Provisional Restoration I. II. Preformed custom crown shells Customized resin restorations 1. Direct technique a. Direct matrix-assisted • • b. 2. 3. Elastomeric or alginate impression Vacuum formed plastic template Direct custom-carved (block-temporary) Indirect technique Indirect-direct (combination) technique
    • Types of Provisional Restoration II. Customized resin restorations 2. Indirect technique • • Initial and final polymerizations occur extraorally The first step is preparing a index (e.g. vacuum shell) on study cast prior to tooth preparation visit
    • Types of Provisional Restoration II. Customized resin restorations 2. Indirect technique Advantages: 1. Improved marginal accuracy 2. Prevention of pulpal and soft tissue irritation 3. Reduced chair time 4. More comfortable for patient
    • Types of Provisional Restoration II. Customized resin restorations 2. Indirect technique Disadvantages: 1. Laboratory procedure required 2. Dental auxiliary required
    • Types of Provisional Restoration I. II. Preformed custom crown shells Customized resin restorations 1. Direct technique a. Direct matrix-assisted • • b. 2. 3. Elastomeric or alginate impression Vacuum formed plastic template Direct custom-carved (block-temporary) Indirect technique Indirect-direct (combination) technique
    • Types of Provisional Restoration II. Customized resin restorations 3. Indirect-direct (combination) technique 1. 2. Indirect: polymerization of acrylic resin on mock preparation of teeth Direct: reline is performed intraorally
    • Types of Provisional Restoration II. Customized resin restorations 3. Indirect-direct (combination) technique 1. 2. 3. 4. 5. 6. 7. Advantages: Allows trial of esthetics, function and speech Provides template for the definitive restoration Ensures color stability Allows incorporation of reinforcement Saves chair time Permits removal and immediate replacement of nonsalvageable teeth Permits long-term treatment
    • Endodontically treated tooth
    • Materials for Provisional Restoration • • • • Poly Methyl MethAcrylate (PMMA) Poly Ethyl MethAcrylate (PEMA) Bis-GMA Light Polymerized UDMA
    • Materials for Provisional Restoration • Ideal requirement of provisional restorative material: – – – – – – – – Biocompatible Dimensionally stable Ease of contouring Adequate strength and abrasion resistance Good appearance Good patient acceptance Ease of adding and repair Compatible with provisional luting agents
    • Provisional Restoration • Cementation – Properties of provisional cement
    • Provisional Restoration REFERNCE Contemporary of Fixed Prosthodontics, 3rd edition (Chapter 15)