The document outlines the trial fitting procedure for dental restorations. It discusses adjusting the occlusion and proximal contacts without anesthesia if possible. It also notes to postpone cementing if the tooth is sensitive and never to cement over a symptomatic tooth. The key steps of the evaluation are to ensure proper proximal contacts, complete marginal adaptation, correct occlusal adjustment, proper contours, and esthetics from a conversational distance.

1. TRIAL FITTING
PROCEDURE
Pre-Insertion
Adjustment

2.  The try-in procedure can be
accomplished on many patients
without administering an anesthetic.
The patient’s unimpaired tactile
sense can be valuable during the
adjustment of the occlusion, and the
annoyance of lingering anesthesia is
avoided. However, if the patient is
uncomfortable by the procedure, an
anesthetic should be given.

3. Cementation should be postponed if
the px reports of tooth sensitivity
under the provisional/temporary
crown. The tooth would be subjected
to a greater chemical and thermal
trauma upon placement of
permanent restoration.
***Never cement a crown
permanently over a symptomatic
tooth.

4. Evaluation of a Restoration should be
carried out in the following sequence:
1. Adjustment of Proximal Contacts
 Proximal contacts of the restoration must
be neither too tight nor too light/loose.
 If too tight, they interfere with correct
seating, produce discomfort and make it
difficult for the px to floss
 If too light/loose, allows food impaction
which is harmful to the gingival and
annoying to the px

5. 2. Marginal Adaptation (Completeness
of Seating)
 After the proximal contacts
have been corrected, seat the
restoration and examine the
margins closely
 An acceptable margin should
not be overextended,
underextended, too thick, or
open

6.  Most common cause of poor
margin adaptation is the failure
of the restoration to seat
completely
 If the proximal contacts are not
too tight and the margins are
still short or open, there may be
some minute undercut, unseen
defect or distortion preventing
seating

7. 3. Occlusal Adjustment
 Only after the resto is seated
completely can occlusal
adjustments be performed
 Use articulating paper and
instruct the px to open and
close his mouth making sure
that the teeth are in their
correct intercuspation once
occlusion is established

8.  Make sure that the markings on
the teeth exhibits evenness, if
not, necessary adjustment
should be made especially on
those areas with darker
markings
 Adjustment of the restoration in
excursive movements is also
essential in establishing the
correct occlusion

9. 4. Contours
 Improper contours may impair
gingival health and detract from
the natural appearance, must
be corrected prior to
cementation
 Excessive convexity near the
gingival margin promotes
plaque accumulation

10.  Surfaces directly occlusal to
furcations are usually
concave and the concavity
should extend occlusally on
the axial surface of the
restoration to improve access
for a toothbrush

11. 5. Esthetics
 Step back and view the
restoration from a
conversational distance to see if
its contours harmonize with the
rest of the px’s dentition
 Let the px look in a mirror so
that any objections to the
appearance can be dealt with
prior to cementation

12. Looking at the
teeth in a wall
mirror shows a
patient how the
restored tooth will
look to others at a
normal conversa-
tional distance.

13. Using a hand
mirror held only
inches from the
mouth allows the
patient to see the
teeth as no one
else will.