Operative dentistry aje qualtrough, jd satterthwaite la morrow, pa brunton

TEMPORISATION
Rationale for use of temporary restorations
Once a tooth has been prepared for an indirect restoration, there 
is usually a delay during which the restoration is constructed in the
laboratory. During this period it is essential to provide a temporary
restoration in order to:
• Protect the exposed dentine, prevent postoperative sensitivity and
provide pulp protection to maintain tooth health.
• Protect the remaining tooth structure and preparation from risk 
of fracture.
• Maintain space by providing stable occlusal contacts to prevent
overeruption of the prepared or opposing tooth.
• Maintain space by providing interproximal contacts with adjacent
teeth to prevent drifting of the prepared or adjacent teeth.
• Be well fitting to allow good plaque control and prevent over-
growth of gingival soft tissues, which may otherwise prevent 
seating of the final restoration.
• Maintain aesthetics.
POOC06 02/18/2005 04:36PM Page 134

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Indirect restorations – further considerations


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Provisional restorations
In most cases in which an indirect restoration is to be provided, the
final result is easily determined and the treatment relatively straight-
forward. In these situations, a temporary restoration need only fulfil
the roles listed above. There are, however, situations in which deter-
mination of the final shape of the definitive restoration is not as easy,
or when there are complicating factors, such as where the existing 
aesthetics or occlusal scheme is to be altered. In such cases, temporary
restorations may also have other roles and it is useful to make the dis-
tinction between simple temporary restorations, which fulfil the roles
above, and provisional restorations, which serve additional functions.
Provisional restorations may be used to:
• Trial a planned tooth shape
• Delay provision of definitive restoration
The great value of a temporary restoration is that it can be used to
‘try out’ a planned shape before construction of the definitive restora-
tion. Such ability is invaluable when considerable alterations are
made to aesthetics, as modifications may be made to temporary
restorations to achieve an acceptable result. Trial of the form of the
restoration is also essential when significant changes are being 
made to occlusal relationships. Should the temporary restorations be
uncomfortable, or suffer repeated fracture or loss of cementation then
the planned occlusal scheme should be reviewed. Similarly, changes
to palatal contour and incisal length of anterior teeth may affect 
phonetics, and this may also be assessed.
Temporary restorations may also be used to delay provision of 
the definitive restoration and can be placed for longer than the short
time usually required. This is useful when periodontal health is com-
promised (e.g. to allow for resolution of gingival inflammation when
previous restorations have had poor margins) or to allow for complete
healing when surgical procedures have been performed. Long-term
temporary restorations may also be useful for intermediate restora-
tion of teeth with questionable prognosis before construction of
definitive restorations (e.g. to allow for peri-radicular healing of
endodontically treated teeth).