adv rest provisionals

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Author:
emm64
ID:
264381
Filename:
adv rest provisionals
Updated:
2014-02-28 12:00:42
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adv rest
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adv rest provisionals
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  1. Requirements of a Provisional Restoration
    • • Pulpal Protection
    • • Positional Stability
    • • Occlusal Function
    • • Easily Cleaned
    • • Non-impinging Margins
    • • Resistance and Retention
    • • Esthetics
  2. Direct Custom Provisional Restorations
    • • (+) Convenient (eliminates plaster cast of prepared tooth/teeth)
    • • (+) Useful for “emergency” crown preparations
    • • (±) Indicated for single units only (no bridges)
    • • (–) Very technique sensitive
    • • (–) Less accurate than indirect
    • • (–) Easily distorted
    • • (–) Can’t be delegated to auxiliary personnel
    • • (–) Risk of locking into undercuts
    • • (–) Risk of thermal or chemical irritation
  3. Bis-Acryl Resins
    • • (+) Chemically similar to restorative composites
    • – - hydrophobic resin + inorganic filler
    • • (+) Low shrinkage
    • • (+) Minimal heat generation
    • • (+) Auto-mix delivery
    • • (+) Can repair using composite
    • • (–) Higher cost
    • • (–) Can’t alter viscosity
    • • (–) More stiff/brittle than traditional acrylics
  4. (Poly) Methyl Methacrylate
    • • (–) Shrinkage
    • • (–) Heat generation
    • • (+) Auto-mix delivery
    • • (+) Can repair using more PMMA or composite
    • • (+) Economical
    • • (+) Variable viscosity
    • • (+) Less stiff than bis-acryl
    • • (+) Good working time
  5. Adding Material to Provisionals
    • • General Recommendations
    • – Proximal contacts:
    • • Add to provisional outside of the mouth, then seat before
    • material sets
    • – Margins
    • • Isolate and lightly lubricate tooth and soft tissue
    • • Seat provisional
    • • Add material directly to margin
  6. Adding to Bis-acrylic (e.g. Integrity)
    • – CLEAN and DRY any areas that will be added to
    • • “Freshen” the surfaces with an acrylic bur
    • • Apply phosphoric acid etchant for 5-10 sec, rinse/DRY
    • – Apply/cure a thin layer of adhesive resin
    • – Apply/cure flowable or conventional composite resin
  7. Adding Composite Resin to PMMA
    • – Why? Esthetic modification of anterior provisionals
    • • Shade change or characterization
    • – Cut back labial surface of provisional with acrylic bur
    • to make space for composite
    • – Apply MMA monomer and dry thoroughly
    • – Apply/cure adhesive resin
    • – Apply/shape/cure composite resin
  8. Adding to PMMA to PMMA (e.g. Jet)
    • – CLEAN and DRY any areas that will be added to
    • • “freshen” the surfaces with an acrylic bur
    • – Lightly wet the cleaned/dried surfaces with monomer
    • – Add material incrementally using the brush technique
    • • Dip brush in liquid, then powder, then apply to provisional

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