DENT204, UNC School of Dentistry PROVISIONAL RESTORATIONS DENT204, UNC School of Dentistry Stephen C. Bayne and Jeffrey Y. Thompson Department of Operative Dentistry School of Dentistry University of North Carolina Chapel Hill, NC 27599-7450

Temporary = Provisional = Non-Permanent = 2-26 weeks INTRODUCTION Definitions Temporary = Provisional = Non-Permanent = 2-26 weeks Short- Term Long- Term TEMPORARY 10 20 30 40 50 weeks Temporary System = RESTORATION + CEMENT EXAMPLES: Temporary crown fabrication procedures: a. DIRECT -- intraoral fabrication (and intraoral/extraoral curing) b. INDIRECT -- extraoral or laboratory fabrication 0s = mix and add to pre-impression; 45s = insert in mouth; 1m = initial set; 2m = remove; 6m= trim; 7m =contour and polish; 12m =cement in mouth.

Preparation of Temporary Bridge INTRODUCTION Preparation of Temporary Bridge Mix. Add to pre-impression. Insert in mouth. Initial set. Trim. Light cure in mouth. Light cure in hand. Trim and polish Cement.

Goals and Desirable Properties INTRODUCTION Goals and Desirable Properties 1. Physiologic goals (protection of hard and soft tissues, stabilization of tooth, function for chewing, therapeutic (pulpal medication), and/or patient comfort) a. Good esthetics -- good color matching and stain resistance (to coffee and tea) b. Good fracture and wear resistance c. Good biocompatibility -- no sensitivity reactions 2. Manipulation goals (ease of use, versatility, low cost, easy to repair) a. Fast reaction, low polymerization exotherm, and high percent conversion b. Minimal surface reactions on curing (O2 and/or impression mtl (e.g., PVS) may cuase surface inhibition) 3. Post-temporization goals (no interference with bonding permanent restorations)

Provisional Restorations and Cements CLASSIFICATION Provisional Restorations and Cements 1. Provisional restorations a. Intracoronal Restorations: (1) ZOE-based and/or ZONE-based temporaries b. Preformed Provisional Shell Crowns (and Cements): (1) Polycarbonate Crowns (2) Metal Alloy Crowns (Al, Anodized Al, Sn-Ag, Stainless Steel, Ni-Cr) c. Custom-Fabricated Provisional Crowns (and Cements): (1) MMA-like products (MMA/PMMA, IBMA/PBMA, EMA/PEMA) – self-cure (2) Epimine-imine products – self-cure (3) Bis-acryl, bis-methacryl, Bis-GMA-like – self-cure, dual cure, VLC (a) Resins (b) Composites 2. Temporary cements: a. ZOE-based or ZNOE-based cements: b. Calcium hydroxide cements c. "Admix cements" (Cements mixed with vaseline or petroleum jelly) d. Composite cements (without bonding systems)

Provisional Restorative Materials PRODUCTS Provisional Restorative Materials

PRODUCTS Temporary Cements

POPULARITY 1999 Provisional Materials Market Share (~$20 Million) Self-Cure Composite Resins 84% Methyl & Ethyl Methacrylates 12% Dual-Cure Composite Resins 4% DMG/Zenith Luxatemp 25% Caulk Integrity 15% ESPE Protemp 32% Kerr Temphase 8% Parkell Snap 5% Bosworth Trim Other All Types 10% Personal Communication: Dr. Ed Shellard-Kerr Corporation

Examples of Chemical, Physcial, and Mechanical Properties Iso-Temp (3M) Luxatemp AutoMix (DMG) Prodigy Composite (Kerr) Z100 Type Temporary Permanent Cure CC DC VLC Cure Time 6-7 m % Shrinkage DT 38 C CS (MPa) 220 263 324 DTS (MPa) 36 41 57 FS (MPa) 80 124 105 BFS (MPa) 104 128 183 190

EXAMPLES Bis-Acryl Materials

EXAMPLES MMA Materials

THANK YOU