Temporization refers to provisional restorations used to establish esthetics, function, and occlusion prior to definitive treatment. Provisional restorations protect the pulp and support periodontal health during treatment. They also allow evaluation of esthetics, occlusion, and patient acceptance of the planned treatment outcome. Common materials for provisional restorations include polymethyl methacrylate resin and various composite resins. Provisionals must meet biological, mechanical, and esthetic requirements and be cemented securely yet removable when treatment is complete.

1. TEMPORIZATION IN FIXED
PROSTHODONTICS
-DR PALAK MISHRA
1ST YEAR PG
RESIDENT

2. DEFINITION
 According to GPT-9
 Temporization is to establish esthetics, occlusal
stability, and function for a limited time in
preparation for the definitive prosthesis; to verify
therapeutic outcome and patient acceptance
before the definitive prosthesis.

3. PROVISIONAL
RESTORATION
TRANSITIONAL
RESTORATION
TREATMENT
RESTORATION
INTERIM
RESTORATION
PROVISIONAL
PROSTHESIS
TEMPORARY
RESTORATION
SYNONYM
S

4. ROLE OF PROVISIONAL
RESTORATION
ABUTMENT
RELATIONSHIP
OCCLUSION MASTICATION
PULPAL
INTEGRITY
PERIODONTAL
HEALTH
SOCIO-
PSYCHOLOGICAL
STATUS OF THE
PATIENT

5. Rosentstiel,land,fujimoto;5th ed

6. RATIONALE
 Protect pulpal tissue and sedate prepared abutments
 Provide an environment conductive to periodontal
health
 Provide method for immediately replacing missing
teeth
 Provide comfort and function
 Protect teeth from dental caries
 Improves esthetics
 Evaluate parallelism of abutments
 Prevents migration of abutments
J Prosthet Dent 2003;90:474-97

7. Requirements
 BIOLOGICAL
 Pulpal protection
 Occlusal compatibility and tooth position
 Prevention of enamel fracture

8.  MECHANICAL
 FUNCTION
Greater stresses likely to occur during mastication.
Strength of poly methyl methacrylate resin is about
1/20th that of metal-ceramic alloy; fracture more
likely.
Partial coverage crown inherently weaker.

9.  Displacement
To avoid irritation to the pulp and tooth
movement, a displaced provisional
must be recemented promptly.
Best prevented: proper tooth
preparation and a provisional with a
closely adapted tooth surface

10.  ESTHETICS
 Color, contour, translucency and texture are key
elements of coronal appearance
 Particularly important in anteriors

11. PROPERTIES
 Better fit, particularly at the margins
 Increased strength
 Better wear resistance
 Easier to keep clean
 Better esthetics and color stability
 Greater occlusal reliability and stability

12. TYPES
 Based on technique:
 Custom fabrication
 Fabrication with preformed material
 Based on material:
 Chemically activated auto polymerising acrlyic resin
 Polymethyl methacrylate (PMMA)
 Polyethyl methacrylate (PEMA)
 Polyvinylethyl methacrylate (PVEMA)
 Heat activated acrylic resins
 Light activated acrylic resins
 Dual light and chemically activated acrylic resins
 Alloys

13.  POLYMETHYL METHACRYLATE (PMMA)
Most preferred
Various shades available; more color
stable
Greatest strength
Flexural strength is higher than composite
resins
Contraindicated in direct technique
Indicated in INDIRECT TECHNIQUE
Low abrasion resistance; good polishability

14.  POLYETHYL METHACRYLATE
(PEMA)
 Best suited for DIRECT TECHNIQUE;
less thermal reaction.
 Low polymerization shrinkage
 Good handling properties
 Good properties
 Good resistance

15.  POLYVINYLETHYL METHACRYLATE
(PVEMA)
Low exothermic reaction while setting
Color stability is less
Lack of transverse strength

16.  BIS ACRYL COMPOSITE RESINS
Available as automix delivery system
Low exothermic reactions
Low shrinkage---good marginal fit and good
transverse strength
Expensive

17.  Repair or modification of bis acryl restoration with
composite : difficult ; dissimal chemistry
 Koumjian & Nimmo demonstrated an 85%
decrease in transverse strength after repair ;
suggesting that the fabrication of a new
provisional restoration is more advantageous
than repair

18.  BIS GMA RESIN
 Good marginal fit
 Low shrinkage
 Stronger than bisacryls;
more brittle
 More likely to fracture in
long span FPDs
 Castleneuvo and Tjan
reported that bis-GMA resin
had a lower rise in
temperature than bis-acryl.

19.  Tempspan- dual curing resin; automixing
cartirage
 Protemp crown (3M ESPE, St Paul, MN)
: preformed bisGMA provisional crown ;
single unit posterior teeth and canine
 Preshaped as adaptable putty needing
marginal trimming, adaptation to the
preparation,light curing, removal,
finishing and cementation.

20.  Visible Light Cured Urethane
Dimethacrylate Resins
Poor stain resistance
Urethanedimethacrylate added; resin
requiring visible light and a
camphoroquinine amine photo initiator ;
polymerization
Prestipino has shown that VLC resins are
brittle; poor choice for a high strength
posterior provisional restorations.
Available in limited shades
More expensive

21. Revotec LC (GC America, Alsip, IL) :
moladble putty available as a thick
rope
Used for temporization of multiple
adjacent crown unit and bridgeworks
 Flowable and hybrid composites can be
used to repair
 However bisacryls and bis GMA resins are
superior in so far as esthetics is concerned

22. PRE FORMED CROWN FORMS
 POLYCARBONATE
 Made of a polymer with high impact
resistance.
 Have sufficient strength
 Name implies that it contain multiple
carbonate groups
 LIMITATIONS
 Often too broad buccolingually so
recontour gingivally

23.  CELLULOSE ACETATE
Thin, soft and transparent.
Disadvantages
Act as matrix, must be removed after their
relining material is set.
Refining material lock into undercut, thus
compromising removal of the material from
gingival area.

24.  STAINLESS STEEL
Available in various sizes
Less malleable, harder to wear and
less likely to deform under load.
Success rate is high
Usually not refined but trimmed
approx. the size of tooth.
Maintain the space that may be lost
when a deciduous tooth is lost
prematurely

25.  ALUMINIUM
Easy to manipulate
Malleable and ductile in nature, easily
bent and trimmed
Corrodes with time
Used as a posterior crown

26. ARMAMENTARIUM

27. INDIREC
T
INDIRECT
DIRECT
DIRECT

28. FINISHING AND POLISHING
 Finishing : surface smoothness
 Polishing: surface luster
 For trimming: acrylic laboratory burs and discs
are used

29. DEFICIENCY
 Marginal inaccuracy
 Dimensional unstablility
 Moisture of oral cavity, temperature changes and
occlusal forces affect the fit
 Longer span of the prosthesis, greater is surface
distortion
 Non integrity of external contour
 Correct shaping of external contour is mandatory
 Fracture
 To strengthen: fibers are used; possesses superior
mechanical, esthetic characterstics

30. REPAIR
 Repair of aged restorations is less
structurally effective
Reduced number of free radicals and
has absorbed water from saliva and
other fluids into its surface

32. CEMENTATION

35. PROVISIONAL LUTING
MATERIALS
 • Provisional luting agents should
possess :
 -good mechanical properties,
 -low solubility,
 -tooth adhesion to resist bacterial and
molecular penetration. • The most
important function of these materials is
to provide an adequate seal between
the provisional restoration and prepared
tooth. This is necessary to prevent

36.  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.

40.  Some of the most commonly used
cements with provisional prostheses are
those containing zinc-oxide and
eugenol. They provide:
 sedative effects that reduce dentin
hypersensitivity
 possess antibacterial properties.

41.  Unfortunately, free radical production
necessary for polymerization of
methacrylate materials can be
significantly hampered by the presence
of eugenol found in eugenol based
provisional luting materials.; Eugenol
interferes with the acrylic resin
polymerization and hardening process .
 Therefore Eugenol-free provisional
luting materials are commercially
available

42.  Baldissara et al recommended that
interim restorations be frequently
evaluated and used for only short
periods of time. Literature reports
advise that if provisional treatment is
required over a protracted time period,
it is best to remove and replace the
provisional luting agent on a regular
basis.

43. REMOVAL OF PROVISIONAL
 Removed when the patient returns
for definitive restoration
 Risk of damage to the prepared
tooth can be minimized if removal
forces are directed parallel to the
long axis of the preparation.
 The BACKHANS or hemostaic
forcep is effective
 Slight buccolingual rocking motion;
breaks cement seal

44. PROVISIONAL VENEERS

45. Recent advancements
 TEMP TABS THERMOPLASTIC
MATRIX WAFERS
Multiuse matrix
Easily adapted to desired shape
No liberation of heat

46.  TUFF TEMP PLUS
Impact resistant rubberized resin
No ploymerization shrinkage
High flexural strength
Eliminates fractures
Marginal fit is perfect

47.  CAD CAM PMMA PROVISIONAL
 Digitally fabricated from PMMA
 Highly precise temporaries
 Milled out from dense block and shows
reduced porosity of traditional hand
processed techniques
 BIOTEMPS provisional crowns and
bridges are created with CAD/CAM
technology

48. So the perfect provisional …
 Super strong
 Highly esthetic
 Gingival sculpting
 Patient fixed
 Universal use
 Cost
 Gentle