ADVANCED ESTHETICS

CREATINGEXCELLENT

FULL CROWNTEMPORARIES:

Materials, Techniquesand Utilization

Frank M. Spear, DDS, MSD

ADVANCEDESTHETICS& INTERDISCIPLINARY DENTISTRY

Education Series

Creating Excellent Full Crown Temporaries: Materials, Techniques and Utilization was produced byAEGIS Publications, LLC, PO Box 1079, Washington Crossing, PA 18977-1079 on behalf of FrankSpear, DDS, MSD. Copyright © 2006 Frank Spear, Seattle Institute for Advanced Dental Education.All rights reserved. No part of this publication may be reproduced in any form without writtenpermission from Frank Spear. Printed in the USA.

WARNING: Reading any chapter or section of Creating Excellent Full Crown Temporaries: Materials,Techniques and Utilization does not necessarily qualify you to integrate new techniques or proceduresinto your practice. AEGIS Publications, LLC, Dr. Frank Spear, and the Seattle Institute forAdvanced Dental Education expect readers to rely on their judgment regarding their clinical expertiseand recommend further education when necessary before trying to implement any new procedure.

The views and opinions expressed in this publication and its chapters are those of the author and donot necessarily reflect the views or opinions of the editors, the editorial board, or the publisher. As amatter of policy, the editors, the editorial board, and any university affiliate do not endorse anyproducts, medical techniques, or diagnoses, and publication of any material herein should not beconstrued as such an endorsement.

Table of Contents

1 Chapter 1: Introduction

2 Chapter 2: Construction

6 Chapter 3: Trimming &Shaping

9 Chapter 4: Refining theAnatomy

10 Chapter 5: Staining &Glazing

11 Chapter 6: Polishing

12 Chapter 7: Cementation/Removal

See Back Cover for Author ContactInformation and Product & Trademark Information

CREATINGEXCELLENT

FULL CROWNTEMPORARIES:

Materials, Techniquesand Utilization

Frank M. Spear, DDS, MSDSeattle Institute for Advanced Dental Education

Education SeriesADVANCED ESTHETICS & INTERDISCIPLINARY DENTISTRY

Introduction

CHAPTER

1

Advanced Esthetics & Interdisciplinary Dentistry Education Series Creating Excellent Full Crown Temporaries 1

Fabricating full crown temporaries is something every dentist does routinely duringtheir week. For the most part, it is a pretty effortless task. The objective is to create

a temporary that fits well, one with the correct occlusion and contacts.However, difficulties arise when creating

temporaries for anterior teeth becausethis area requires more attention. Foranterior teeth, temporaries become theblueprint for the final restoration in termsof occlusal guidance, smile line, toothposition, and tooth color. Additionally,anterior temporaries do things that aroutine posterior temporary can’t do,and they can help build your practice bybolstering your patients’ confidence. Therefore, it is critical that anterior temporariesbe truly exceptional.

Today, a variety of self-cured composite temporary materials are used for full crownanterior and posterior temporaries (Table 1.1). The manner in which they are used issimilar. However, the material itself is not as significant to the appearance and functionof the resulting temporaries as the amount of time and attention to detail that goesinto creating them (Figure 1.1).

Additionally, well-made and accurate temporaries not only look good, but also con-tribute to gingival health while the patient is wearing them (Figure 1.2). If poor tissueresponse is evident upon removal of a temporary, it’s the result of an inaccurately fittingtemporary that did not promote hygiene, lacked the necessary gingival and facialembrasures, and was most likely created too quickly.

Therefore, it’s important to allow sufficient time to properly contour and finishtemporary restorations, and the fee for this work and the related process should beaccounted for in the restorative fee schedule presented to the patient. For example, ifyou are going to create a set of anterior temporaries that will be the template for thecase, those temporaries should add roughly 30% to the overall cost of the treatment.This will enable you to spend the time necessary to refine their occlusion, properlycontour them, and develop their esthetics into something the patient can be proud of(Figure 1.3).

1.1 View of full crown temporaries inthe patient’s mouth.

1.2 Removing provisional restorationsoften elicits tissue bleeding,complicating the adhesive phaseof the restorative process.

1.3 View of highly esthetic, completelyfinished anterior full crowntemporary restorations.

Table 1.1 COMMONLY USED TEMPORARY MATERIALS

• Integrity™

• Luxatemp® Automix Plus

• Protemp™ 3 Garant™ Temporization Material

The fabrication of all full crown temporaries requires a matrix into which the tem-porary material will be placed and which will enable you to control the overall

contour and shape of the temporaries (Figure 2.1). One pressure formed material thatcan be used for creating the matrix is Copyplast, which is highly detailed and flexible.

Creating the matrix involves several steps (Table 2.1). First, make a model of thepatient’s preoperative condition. If you or the patient don’t like something about theteeth (e.g., shape, length, contour), then mock up the model using composite. If moreextensive changes are required (e.g., adding several millimeters to the incisal edges oropening up the vertical dimension), a diagnostic wax-up is preferred. Then, duplicatethat mock-up or wax-up using an alginate impression material. Finally, press the 1.5 mm

Copyplast material onto that duplicatemodel using a pressure former (Mini Star).

Anterior full crown temporaries can beconstructed directly in the mouth follow-ing tooth preparation and final impressiontaking, or using an indirect technique.Regardless, always make your temporariesafter pulling the retraction cord for takingthe final impression (Figure 2.2). In orderto produce a properly fitting full crown

temporary, you must capture the margin with acrylic just as you would capture it withsilicone or polyether. Therefore, pull the retraction cords, then your impressions. Ifthose margins aren’t visible, repack the teeth (Figure 2.3) and take another impression.

Direct in-the-mouth Technique1. Load the matrix with the temporary material, seat it into place (Figure 2.4), and let

it cure.2. Because all self-cure composite temporary materials may, at one time or another,

be subject to air bubbles, carefully inspect the temporaries upon removal from themouth and removal of the matrix.

2 Creating Excellent Full Crown Temporaries Advanced Esthetics & Interdisciplinary Dentistry Education Series

Construction

CHAPTER

2

2.1 View of a Copyplast matrix.

2.2 View of the retraction achieved forimpression taking for a patient withmissing teeth.

2.3 In the same case, the cord is repackedto promote better visibility of themargins in the final impression.

2.4 In the same case, view of the matrixloaded with temporary material forthe creation of direct temporaryrestorations.

Table 2.1 MATRIX CONSTRUCTION

• Make a mock-up or wax-up of the patient's teeth

• Duplicate the model

• Create the 1.5 mm Copyplast pressure formed matrix

3. Add just a touch of flowable composite to the area affected by the air bubble andlight-cure it (Figure 2.5).

4. Trim and finish the temporaries and seat them with your cement of choice (Figure 2.6).5. If the temporaries do not fit ideally, relining of the margins may be necessary

using flowable composite. To accomplish this, air abrade the internal aspects ofthe temporaries, apply a single-bottle adhesive (Adper™ Single Bond Plus), andinject the flowable composite around the preparations. Then, seat the temporariesover the flowable composite and light cure for five seconds.

Indirect TechniqueAlternatively, full crown temporaries can be constructed indirectly, which allows

total control of their shape and form because they are created on a model. Additionally,the indirect technique enables you to actually prepare the teeth, make the impression,and delegate temporary fabrication to someone in the office trained to make them.

The following steps demonstrate the technique for making indirect temporariesusing a die silicone model.

1. Once the teeth have been prepared, make an alginate or polyether impression ofthe preparations for use in creating the die silicone model (Figure 2.7). Note: youshould not use a polyvinyl siloxane impression material when working with the die sil-icone; the two materials will stick together.

2. At your workstation, place the tip on the syringe of the flowable addition-reactiondie silicone (Mach-2®) and inject the die silicone into the impression by placingthe syringe tip straight down in the base of the impression, loading it just up tothe free gingival margin (Figure 2.8).

3. Proceed to the other side of the impression, and inject the die silicone into it in a sim-ilar manner. Within a matter of minutes, you have a silicone model.

4. Add a base to the model using bite registration paste (Futar®). Inject the pasteover the silicone and across the palate in order to create a flat base on the model(Figure 2.9). Apply sufficient bite registration paste so that the model can beinverted and placed on a plastic plate to harden. Note: this flat base will prevent themodel from warping when making the temporaries.

Chapter 2: Construction

2.5 Flowable composite is added tothe area containing an air bubble.

2.6 View of the direct in-the-mouthtemporaries after placement in the mouth.

2.7 View of the impression used formaking the model.

2.8 View of the die silicone beinginjected into the impression.

2.9 View of the bite registration paste being injected to create the base plate.



5. Once the model base (i.e., bite registration paste) is firm, remove the plastic plate.6. Now, try the matrix onto the model to ensure complete seating (Figure 2.10). The

most common areas of interference occur in the palate or from the labial flange.7. If the matrix has seated correctly, remove it and begin loading your temporary

material fully into it (Figure 2.11). For demonstration purposes, the Protemp 3Garant Temporization Material in shade A1 is used.

8. Take the fully loaded matrix back to the model, seat it into place, and put it downon the plastic pad, which should be level so that you can press down on it firmlywithout distorting the model.

9. Wait a sufficient amount of time for the temporary material to cure. Alternatively,the fully loaded and seated matrix/model can be placed in the Triad® 2000™Visible Light Curing Unit for two minutes to ensure complete curing.

10. After curing, simply peel the loaded matrix off of the model and then off thetemporaries (Figure 2.12). Because the model is silicone, the temporaries will notlock onto it.

11. Prior to trimming, remove excess/bulk temporary material that ran across thesilicone model.

12. Additionally, because all of the composite temporary materials produce an oxygeninhibition layer, place the temporaries in alcohol for five to 10 seconds.

Alternative Stone Model Technique for Ovate PonticsThe indirect technique can also be completed using a stone model. The advantage

of using a stone model compared to the silicone model is that it is much easier to carvestone. This is important when making full crown temporaries that require an ovatepontic (Figure 2.13).

In such cases, simply make a second impression, but instead of using the die siliconealone, use a combination of 50% die silicone and 50% Whip Mix mounting stone tocreate the model. This will enable you to use a bur to carve the ideal ovate pontic siteinto the model in the area of the missing tooth.

After making the model, simply mark it in pencil to show where/how the correctovate pontic form should be (Figure 2.14). Then, use your bur to carve the correct forminto the model prior to loading and seating your matrix with the temporary material.


2.13 View of a patient requiring a remakeof her anterior bridge.

2.14 The stone model is marked withpencil to identify where it should becarved for placement of the ovatepontic.

2.11 The matrix is loaded with thetemporary material.

2.12 The matrix is peeled from the hard-ened temporaries, which are nowready to be trimmed.

2.10 The Copyplast matrix is seated ontothe model.


Once the indirect temporary is complete (i.e., after completing the other steps out-lined in this manual), it will serve as the template for augmenting the gingival tissue.Simply spray occlude spray on the bottom of the pontic and place in the mouth tomark exactly where on the ridge modifications should be made. Then, contour theridge using a laser or electrosurgery unit until the temporary seats completely.

Bridge ReinforcementFor bridge temporaries, reinforcement is sometimes necessary, and many products

are available for this purpose, including GlasSpan flexible ceramic ropes and tapes. Theropes, in particular, are small and provide cylindrical fiber reinforcement; they areavailable in small, medium and large sizes.

1. To reinforce a bridge temporary for which the pontic area requires additionalstrength (Figure 2.15), create your model and your matrix, as described previously.

2. With this case as an example, place the medium sized GlasSpan rope on themodel of the prepared teeth, beginning with one cuspid, and tack it into placewith flowable composite (Figure 2.16).

3. Then, move the GlasSpan over to the next tooth and tack it with flowable compos-ite. Continue along all preparations for the temporary bridge restoration.

4. Once the reinforcing rope is in place, cut off the excess. However, to keep the ropefrom fraying, paint it with dentin adhesive precisely where you plan to cut it andlight cure it. Then, cut through the cured rope.

5. Now, mould the rope to the preparations, bearing in mind that the loaded matrixmust still be able to fit properly on the model. Additional flowable composite canbe used to ensure that the rope does not flex or distort when the loaded matrix isplaced (Figure 2.17).

6. Load your matrix with the desired temporary material and seat onto the matrix, asdescribed previously, and continue the construction process as outlined (Figure 2.18and 2.19). Note: this type of bridge temporary can easily last for between six and 12 months.


2.16 The GlasSpan rope is placed on thepreparations on the model andtacked into place with flowablecomposite.

2.15 View of a patient missing his incisorswho will be wearing the temporaryfor a prolonged period of time.

2.19 View of the patient with the completed reinforced temporarybridge in place.

2.18 The matrix is loaded with temporary material and seated onto the reinforced model.

2.17 More flowable composite was addedto the GlasSpan rope to make itbulkier and less likely to flex.

3.6 Demonstration of how to use flow-able composite to outline the mar-gin around the facial aspects ofeach temporary.

3.5 View showing how to handle themargins if a concavity must befilled.


Trimming & Shaping

3.4 View showing movement of the burinward and across the buccal andthen the lingual surfaces.

3.3 View of all margins clearly high-lighted using a red pencil.

3.2 View of assorted Brasseler burs con-tained in the Seattle Institute forAdvanced Dental EducationProvisional Kit.

3.1 View of a lab station equipped withan electric handpiece, vacuumsystem, compressed air, and curinglight/unit.

When trimming and shaping temporaries, a useful tool for the dental office is aworkstation equipped with an electric handpiece, vacuum system, compressed

air, and a curing light/curing unit (Figure 3.1). Additionally, the workstation may beequipped with sterilized burs for trimming and shaping that are contained in theSeattle Institute for Advanced Dental Education Provisional Kit (Figure 3.2).

To begin trimming full crown temporaries, ensure that all margins are clearly visi-ble by highlighting them using a red pencil (Figure 3.3). This will help prevent over-trimming and under-trimming the margins, as well as leaving an overhang.

1. Once the margins have been marked, begin trimming the full crown temporary atthe buccal and lingual margin using a flame shaped acrylic bur. This bur is appro-priate for full crown temporaries based on the bulk of the temporary material.

2. Move the bur inward and across the buccal and then the lingual surfaces (Figure 3.4).3. Run the bur up to the marked red line on the facial surface, partially into the

interproximal embrasure. Trim the entire facial and lingual aspects of the tempo-raries in this manner.

4. Once the basic buccal and lingual aspects have been trimmed to the margin,begin trimming the interproximal region.

Correcting Marginal Concavities1. If you notice a slight concavity on the surface of the temporaries, the matrix may

have been too tight on the model. To recontour the temporary, ensure that all ofthe basic buccal and lingual margins fit correctly by trying the temporaries backon the silicone model.

2. If there is a concavity to be filled, handle the margins as if the temporaries need tobe relined (Figure 3.5).

3. Prepare the temporary by air abrading it with 50 µm aluminum oxide and thenpainting a single-bottle adhesive (Adper Single Bond Plus) onto the facial surface.

4. Once the adhesive has been placed, use flowable composite to outline the marginaround the facial aspects of each preparation and then seat the temporary on thesilicone model (Figure 3.6).

CHAPTER

3


Chapter 3: Trimming & Shaping

3.7 View showing how to use the adhe-sive brush to wipe down the facialaspect to “feather out” the composite.

3.8 View of the extension of acrylic thatwould appear beyond the margin ofthe preparation if the margins wererealigned correctly.

3.9 View showing how to hold the discparallel to the root of the temporarywhen beginning to trim the gingivalembrasures.

5. To fill in the concavity, paint the concavity to its shape using just the tip of theflowable material.

6. In order to avoid much more trimming, use the adhesive brush to wipe down thefacial aspect to “feather out” the composite (Figure 3.7), then light-cure it for 30 sec-onds. Ideally, the temporary can be placed in the Triad curing unit for 30 seconds.

7. To remove the oxygen inhibiting layer, place the temporary in alcohol.8. After removing it from the alcohol, dry the temporary and mark the margins

again with red pencil. If the margins were relined correctly, there should be anextension of acrylic beyond the margin of the preparation (Figure 3.8).

9. Now, using the pointed and shaped acrylic bur, continue refining the facial mar-gin to the marked line. Note: because the concavity has been filled in, the contourappears more esthetic.

10. Remember that putting tremendous effort and time into ensuring that the tem-poraries fit well contributes to the condition that the gingival tissue will be inwhen seating the definitive restorations. If the temporaries fit properly and themargins are well contoured, there is less likelihood of experiencing inflamed gin-giva when the final restorations are seated.

Resume Interproximal & Embrasure Contouring1. Once the buccal and lingual surfaces have been finished, continuing trimming

and shaping interproximally. For posterior temporaries, use either a flexible discor a double-sided stiff and coarse diamond disc. For anterior temporaries, the veryflexible, ultra thin and double-sided 9 11 H disc is preferred.

2. Begin trimming the gingival embrasures by holding the disc so that it is parallel tothe root of the temporary (Figure 3.9), beginning first with the lateral and thenthe central.

3. Turn the temporaries around to trim the embrasures from the lingual aspects of thelateral and then the central. Note: throughout the process, a fairly slow speed is used;working in this manner creates the emergence profile against the root of the temporary.

4. Be sure that the midline of the two central incisor temporaries is correct. Examinewhere the two roots of the centrals are and make a little notch between them toidentify the midline’s location. Lean the disc against one central and then againstthe other central (Figure 3.10).

3.10 View demonstrating how to notchbetween the two centrals and leanthe disc against one central andthen the other to create the propermidline.


Chapter 3: Trimming & Shaping

3.14 View of the completely trimmedand shaped temporaries.

3.11 Illustration showing proper incisaledge plane.

3.12 View showing how to use the9 11 H disc when working on themodel to properly define the incisalembrasure.

3.13 Demonstration of how to completethe trimming of the mesial aspectof the lateral by pulling the disc tocreate a curved surface.

Incisal Edge Adjustments1. Place the temporaries back on the model and ensure that the incisal plane is cor-

rect (Figure 3.11). Any incisal edge adjustments should be made at this time,prior to further finishing.

2. Use a gray ceramic pre-polishing wheel to adjust the incisal edges by creating avery flat edge on it. Use a coarse double-sided, very stiff diamond disc for support.

3. Use this pre-polishing wheel to create a flatter incisal edge, if desired, or impartother desired incisal contours.

4. After the incisal edges have been properly adjusted, define the incisal embrasures(i.e., make them large or small, depending on the characteristics desired in thetemporaries) and connect them to the previously carved cervical embrasures. The9 11 H disc can be used for this purpose, working on the model (Figure 3.12).

5. To refine the facial embrasures, hold the temporary in your hands and, using the9 11 H disc, begin at the cervical and work up into the insisal embrasure.

6. Next, turn the temporary around to complete the mesial of the lateral by pullingthe disc to create a curved surface (Figure 3.13).

7. Continue with the other side, using the bending action of the disc to create thecurved form of the embrasure and the line angle of the tooth. Proceed with thedistal aspect of the central and finally, the midline.

8. Drag the disc along the mesial line angle of each temporary to provide some con-tour in those areas to complete the trimming process (Figure 3.14).

Refining the Anatomy

CHAPTER

4


When fabricating full crown temporaries on silicone models, the Protemp 3Garant Temporization Material shrinks by approximately 3% to 4%. As a result,

it will be snug when placed in the mouth.This can be corrected by relining the

temporary at some point during the fab-rication process. To do so, select a smallacrylic bur and run it lightly inside thetemporary, primarily in the marginalregion, relining it just enough to provideroom for cement and ensure it fits prop-erly (Figure 4.1).

To refine the anatomy:1. Run a fairly fine fluted acrylic bur

over the facial surface of the tempo-raries to create a relatively smoothsurface.

2. When working from wax-ups, thecentrals can become very convex. Tocreate centrals with a definite flatlabial surface, run the bur in suchan orientation so as to impart a flatplane that produces esthetic lightrefection (Figure 4.2).

3. Repeat this process on the laterals toensure that the temporaries are nottoo convex, but instead demonstratea nice flat surface anatomy.

4. To create lobes or convexities that mimic those found in natural teeth, use theround tip of an acrylic bur. Run the bur tip vertically on the mesial aspect of bothcentrals to create a concavity in that location (Figure 4.3).

5. Run a bit of the bur tip on the distal aspect of the centrals, also, to create a con-cavity (Figure 4.4).

6. Next, run the bur on the mesial aspect of the laterals. 7. To blend the concavities and impart texture into the temporaries, run the

rounded edge of the bur horizontally to the concavities that were just completedin order to create striations in the surface (Figure 4.5). Note: some of this texturiza-tion will be filled when staining the temporaries; if too much texture has been created,realize that some will be lost during the final staining, glazing, and polishing process.

8. Now, check the cervical embrasures. Do they need to be opened or not? Payparticular attention to whether the embrasure is closed relative to the papilla. If itis closed relative to the papilla, it will hold the papilla in that position once thetemporary is cemented.

9. To open gingival embrasures, use a 9 11 H ultra thin disc and open them approx-imately .5 mm to provide space to the papilla (Figure 4.6).

10. Verify that interproximal space has been created by trying the temporaries on themodel. Floss should pass easily through the cervical embrasures.

4.1 View of the selected small acrylicbur as it is used to lightly reline theinside of the temporary.

4.2 View illustrating the orientation ofthe bur against the temporary inorder to create centrals with adefinite flat labial surface.

4.3 View demonstrating how to hold/place bur tip against temporariesto create lobes or convexities in thecentrals.

4.4 View illustrating how the bur tip isalso run on the distal aspect of thecentrals to create a concavity.

4.5 View showing how to run therounded edge of the bur horizon-tally to the previously createdconcavities for blending.

4.6 View demonstrating the orientationand angle of the 9 11 H ultra thindisc when opening the gingivalembrasures.


Staining & Glazing

CHAPTER

55.1 Color is first applied cervically and

interproximally on all of thetemporaries.

5.2 Image demonstrating how even asmall amount of color can changethe appearance of temporaries froma shade A1 to a shade A2 or A3.

5.3 View demonstrating that excesscolor to highlight the incisal edgecan be wiped over using the clearsealant.

5.4 View illustrating the proper applica-tion of the final glaze layer—justsufficient glaze to seal the color.

5.5 View demonstrating the use of alathe to impart a natural luster tothe temporaries.

After refining the anatomy, colorant and glaze is applied to the full crown tempo-raries. For demonstration purposes, orange and blue porcelain stains—and a

light-cured denture sealant (Palaseal)—are used.1. Apply a very thin wash of Palaseal to coat the temporaries.2. Then, begin to add color. For these temporaries, orange is applied cervically and

interproximally on each (Figure 5.1). The surface texture, concavities, and convexi-ties that were created using the round end of the bur should be visible.

3. Use only a small amount of color; it does not take much to effectively change theshade of the temporary. For example, these temporaries were fabricated fromshade A1 of the Protemp 3 Garant Temporization Material, but the colorant iseasily turning them to an A2 or A3 (Figure 5.2).

4. Now, highlight the translucency of the incisal edge. Here, blue is used. Excesscan be applied and wiped over with a fresh layer of clear Palaseal for blending(Figure 5.3).

5. Set the colorant with a curing light according to the manufacturer’s instructions.6. Apply the final glaze layer completely over all temporaries. Do not apply too

much glaze because the surface anatomy could be lost. Apply only enough to sealthe color (Figure 5.4).

7. Bake the temporaries for two minutes in the Triad curing unit. Note: temporariesfabricated in this manner can routinely function esthetically for six months.

8. Remove the temporaries from the curing unit and examine before proceeding tothe lathe. Verify fit, color and contours on the model.

9. Use the lathe to impart a natural luster, one that isn’t too dull or too shiny, similarto natural teeth (Figure 5.5).

Polishing

CHAPTER

6


Polishing is the last step necessary to complete the full crown temporaries.1. Using a completely wet chamois wheel, begin on low speed, polishing the lingual

surface first with plenty of pumice mixed with water (Figure 6.1). Note: working ata low speed provides more control.

2. Polish the facial surface of the temporaries on low speed initially, also.3. Take care not to let the wheel catch the incisal edge.4. Keep the wheel moving using plenty of wet pumice. Note: the denture sealant that

was applied to the stain is durable during the polishing process.5. Rinse the surface of the temporary with water and examine its appearance (Figure

6.2).6. To achieve the desired luster, switch to a dry wheel at low speed and use a small

amount of universal polishing paste to bring the temporaries to a very high shine.Polish the labial and lingual aspects of the temporaries in this manner (Figure 6.3).

7. For a higher shine, raise the speed. However, take care not to lose control of thetemporaries.

8. Examine the temporaries. They should demonstrate enamel-like luster, as well asthe surface anatomy that was originally created.

9. Finally, clean the temporaries using either a brush or ultrasonic prior to cement-ing in the mouth.

6.1 View showing a completely wetchamois wheel on low speed withplenty of pumice mixed with water.

6.2 To evaluate the polishing progress,rinse the temporaries with waterand examine.

6.3 Illustration of how to use a drywheel and universal polishing pasteto achieve a very high shine in thetemporaries.


Cementation/Removal

CHAPTER

77.1 View of Miltex carbide tipped

hemostats that can be used forremoving temporaries.

Contrary to what most people use these days for cementing full crown temporaries,zinc oxide eugenol cements—such as TempBond® and Fynal®—can be used.

The latter, in particular, is a reinforced zinc oxide eugenol cement that is strong anddesensitizes the tooth; anesthetic is rarely needed.

Questions may arise regarding bonding of the definitive restorations if an eugenolcement has been used for temporary restorations. Eugenol contaminates bonding andinterferes with the polymerization of resin if it is free eugenol. However, after one weekin the mouth, this author has found that there is no free eugenol left in these cements.

Regardless, it is prudent practice to always clean preparations after removing thetemporaries and before cementing the final restorations. Preparations can be cleanedwith either air abrasion—which requires anesthetizing the patient—or by usingpumice and a rubber cup. If the temporaries have been placed using Fynal, this authorhas found that, when they’re removed, the cement has remained in the temporaries. Asa result, cleaning the preparations with pumice—and without the need for anes-thetic—is simplified.

Because this temporary cement is strong, questions have been posed about how tosuccessfully remove the temporaries. Carbide tipped hemostats (Miltex, Inc.) that allowyou to grab the temporary, squeeze it, and then rock it enable you to simply lift it off(Figure 7.1); only rarely will a temporary need to be sectioned in order to be removed.


Notes

Author Contact Information

Frank M. Spear, D.D.S., M.S.D. Seattle Institute for Advanced Dental Education 1-888-575-0370; Outside the United States: 1-206-322-0370www.seattleinstitute.com

Product & Trademark Information

• Carbide tipped hemostats; Miltex, Inc., York, PA• Copyplast; Mini Star; Whip Mix; Great Lakes Orthodontics, Tonowanda, NY• Fynal®; Integrity™; DENTSPLY Caulk, Milford, DE• Futar®; Kettenbach GmbH & Co. KG, Eschenburg, Germany• GlasSpan flexible ceramic ropes; GlasSpan, Inc., Exton, PA• Luxatemp® Automix Plus; Zenith/DMG, Englewood, NJ• Mach-2®; Parkell, Inc., Edgewood, NJ• Palaseal; Heraeus Kulzer, Armonk, NY• Protemp™ 3 Garant™ Temporization Material; Adper™ Single Bond Plus;

RelyX™ Luting Cement; 3M™ ESPE™, St. Paul, MN• Seattle Institute for Advanced Dental Education Provisional Kit; Brasseler

USA®, Savannah, GA• TempBond®; Kerr, Orange, CA• Triad® 2000™ Visible Light Curing Unit; DENTSPLY International, York, PA

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