Provisional restorations are designed in order to protect oral structures and promote function and esthetics for a limited period of time, after which they are to be replaced by a definite prosthesis. They play a particular role in diagnostic procedures and continued evaluation of the treatment plan, as they should resemble the form and function of the definite rehabilitation that they precede. Therefore, interim treatment should satisfy the criteria of marginal adaptation, strength, and longevity. In complicated treatment plans that intend to last for extended periods of time, the function of provisional prostheses involves the possibility of relining, modification, or repair. These adjustments raise considerations regarding the strength of the resultant bond. Chemical composition of the base and repair material, surface characteristics of fracture parts, and time elapsed since the initial set of the rehabilitation should be considered in the decision of the appropriate repair material and technique. Proper pretreatment of the provisional components' surfaces is essential to ensure bonding as well.The purpose of this article is to illustrate the management of provisional restorations' deficiencies. This article highlights possible failures of custom-fabricated provisional restorations, describes methods to prevent their occurrence, and discusses clinical techniques for their management. Finally, the proper combination of materials and surface preparation to achieve the optimum treatment outcomes are presented.
CLINICAL SIGNIFICANCEProvisional restorations' failures and other deficiencies are encountered by clinicians on a daily basis. Adequate laboratory techniques and material combinations presented herein may contribute to their efficient and predictable modifications and repairs. (J Esthet Restor Dent 24:26-39, 2012) The interim treatment focuses on protecting pulpal and periodontal health, promoting guided tissue healing in order to achieve an acceptable emergence profile, evaluating hygiene procedures, preventing migration of the abutments, providing adequate occlusal scheme, and evaluating maxillomandibular relationships. 2-6 From the clinician's standpoint, provisional restorations play a key role in the diagnostic procedures and continued evaluation of the treatment plan, as they must resemble
SUMMARY
Clinical experience supports the notion that the restoration of MOD cavities may pose a challenge to the practitioner. Proper placement of precontoured matrices and commercial wedges help the clinician to establish an optimal emergence profile and sufficient contours. However, the presence of proximal concavities in premolars or molars can turn the reproduction of previous cervical architecture into an even more demanding task. Wedges with customized form or adequate design can precisely conform the matrix to the cavosurface area and prevent any gap formation. This article presents two different options that allow for successful and predictable reestablishing of anatomically correct contours and optimal proximal contacts in posterior teeth with proximal concavities.
Implant-retained overdentures can significantly improve the patients' function. The esthetic performance of these restorations however, may not be satisfying the patients' expectations and demands. Customizing the artificial gingival areas and individual staining of the prefabricated acrylic teeth may improve the esthetic performance creating natural-looking removable prostheses.
The rehabilitation of the edentulous mandible with implant-supported overdentures and telescopic copings is a viable clinical solutions with multiple clinical advantages both for the clinician and the patient. . Immediate loading can be applied in cases where increased initial stability can be achieved. More extended long-term clinical studies with increased number of patients and implants are needed, however, to verify the efficacy of the treatment method.
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