Ask the Expert: An Interview with Nate Lawson, DMD, MA, PhD on the Fabrication of Temporary Restorations

This scenario can create a time-management headache in a busy clinical setting. In this case of a fractured crown (FIG. 1) where a portion of the crown remains cemented on a vital tooth, the patient was experiencing sensitivity due to exposed dentin and required immediate temporary coverage.

Patient presented as an emergency patient with a fractured ceramic crown. The tooth was vital and the patient was experiencing sensitivity due to exposed dentin.

In any clinical setting, available chair time may be limited and may not allow for obtaining an impression of the fractured tooth along with the opposing dentition and fabricating a temporary matrix from an ideal wax-up. Therefore, the clinician may build up the tooth with old or expired composite or wax and then take an impression of the tooth. One challenge with this method, however, is that the composite or wax buildup may dislodge from the tooth in the process of taking the impression of the tooth. In order to avoid this another technique was utilized. An impression of the non-intact tooth was taken using Template Ultra Quick Matrix Material (Clinician’s Choice) in a Quad-Tray Xtreme (Clinician’s Choice) dual-arch impression tray. (FIG 2)

An impression of the fractured crown was taken quickly with Template in a Quad-Tray Xtreme.

The remaining restoration was then removed from the impression using a bur in order to provide room for a full thickness temporary. It was necessary to perforate the temporary impression in order to gain sufficient space. (FIG. 3)

The areas of the missing crown structure were removed with a rotary instrument. It is important that sufficient material is removed to allow for adequate thickness of temporary material.

At this point, the temporary impression was set aside until the tooth was re-prepared for the new restoration. Once the temporary crown was fabricated using Inspire Esthetic Provisional Composite (Clinician’s Choice), it was necessary to quickly recontour and establish proper occlusion as well as remove some flash that resulted from the perforated impression. This was easily accomplished with finishing burs prior to cementation. (FIG. 4)

The temporary crown was removed from matrix and quickly recontoured to remove bulk and flash and then polished.

Cling2 Resin Optimized Temporary Cement (Clinician’s Choice) is ideal for providing a stable, healthy and sensitivity-free temporization stage. (FIG. 5)

The temporary crown was cemented with temporary cement. Occlusion was adjusted. Note that this method may not create anatomic occlusal contours unless clinician creates them with finishing burs.