Dr. Inas Ayoub Elalem inas.alalem@gmail.com Al Azhar University Gaza, Palestine Uploaded by Dr. Lama El Banna Operative dentistry fourth year Temporary Restorations

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Dr. Inas Ayoub Elalem
inas.alalem@gmail.com
00970599448344
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Operative Dentistry IV

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Temporary
Restorations
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3. Temporary restorations are those restorations,
which are inserted into the prepared cavity,
only for a certain period of time till replaced
by a permanent restoration. In indirect
restorations, it serves as a substitute restoration
while a permanent restoration is being
fabricated in the laboratory. They can be also
called intermediate or provisional restorations.

4.  According to the time period of their
placement they can be divided into three
categories:
A. Short term temporary restorations (placed
for 1-2 weeks).
B. Medium term temporary restorations
(placed for several weeks).
C. Long term temporary restorations (placed
for 6 months).

5. I. Objectives of temporary restorations:
1. Protection of the dentin-pulp organ:
Temporary restorations will seal the
cavity against food debris, saliva and
bacteria. If the cavity is left without a
provisional restoration, pain will occur. Pain
will be a response and not reflecting an
inflammatory condition. However, long
term dentin exposure may lead to
inflammatory response.

6. 2. Sedation of the dentin-pulp organ:
If the cavity is left opened without a dressing,
pain will occur. External stimuli, such as hot or
cold food, will stimulate pain. Pain sensation
can be explained on the basis of the hydro-
dynamic theory of pain sensation laid by
Brannstrom in, 1966; i.e. movement of the
dentinal tubule contents will irritate the nerve
endings (mechanoreceptors) which in turn
cause pain. This type of pain is characterized as
very brief, sharp type of pain.

7. 3. Restoration of occlusion:
Provisional temporary restoration will
restore the occlusion and will prevent the
tooth from tilting, drifting or over-eruption, if
left for a long period with temporary
dressing.

8. 4. Protection of the periodontium:
This is especially true in Class II cavities.
Leaving the proximal surface without
provisional temporary restoration will invite
food impaction to occur with its
complications on the periodontium.

9. 5. Putting the tooth into function:
This is very important, as concentration of
occlusal stresses will be distributed on both
sides otherwise only one side will be
functioning and the other side will be non-
functioning.

10. 6. Protecting the tooth from fracture:
Putting a provisional restoration into the
cavity will protect the tooth against fracture
under the components of forces.

11. II. Requirements of an ideal temporary
restoration (goals):
Manipulation goals:
 Ease of use.
 Ease of placement, shaping and
removal.
 Ease of repair.
 Efficient reaction with no or little
exothermic heat.
 Fast setting.

12. Physiologic goals:
 Protection of both hard and soft tissues.
 Therapeutic actions (sedative - anticarigenic
potential - bactericidal effect).
 Patient comfort.
 As functional as possible to facilitate
chewing.

13. Materials performance goals:
Good fracture and wear resistance (high
strength).
Good biocompatibility (no sensitivity or toxicity
reactions).
Good esthetics ( good color matching and stain
resistance).
No or little solubility and disintegration.
Radio-opaque.

14. Post temporization goals
No interference with the setting reaction of
the permanent restoration.

15. III. Types and Indications of Temporary
Restorations:
1) Conventional zinc-oxide and eugenol:
Zinc oxide and eugenol paste is
considered as an obtundent, disinfectant
and is the best sealer of the cavity against
saliva and bacteria. Eugenol containing
dressings have significant antimicrobial
activity due to their slow release of zinc
and eugenol.

16.  Furthermore eugenol has been shown to
depress the irritability of the nerve endings,
so it is used as an obtundent. Conventional
zinc-oxide eugenol temporary restorations
is usually used in posterior teeth prepared
for amalgam restorations.

17. 2) Modified zinc-oxide and eugenol:
It consists of conventional zinc oxide
powder reinforced with several additives, such
as silica and alumina fillers or ethoxybenzoic
acid to increase the strength and decrease the
setting time. It is indicated in either extensive
cavities or for long term temporization.

18. 3) Non-eugenol temporary restorations:
They are presented as single paste system
in collapsible tubes or well sealed jars to
avoid their premature setting and to extend
their shelf life. Moisture contamination will
lead to premature setting of ready made
temporary fillings.

19. The popularity of readymade temporary
restorations comes from:
Simplicity of application.
No eugenol residues are left which may
interfere with setting reaction of resin
restorations and bonding of direct esthetic
restorations. Thus, they are highly
recommended in preparations in anterior
teeth.

20. 5) Temporary restorations for indirect restoration as
(inlay/onlay/overlay) preparation:
 Types:
A. Direct temporary resin restorations:
Either chemically cured or photo-cured commercial
preparations are used. They are characterized by enough
strength, hardness and insolubility in oral fluids. They are
used for temporary restorations of indirect restoraiton
preparations and temporary crowns. They are cemented
using temporary cement.

22.  Technique:
1. Prior to tooth preparation, a silicon impression is
taken using a sectional tray
2. After tooth preparation, equal parts of base and
catalyst from the chemically cured resin are mixed
in a mixing pad then, packed into the impression of
the specified tooth.
3. The silicon impression is re-inserted in the patient's
mouth and left till setting of the resin takes place.

23. 4. After removal of the impression the excess
resin is trimmed and the temporary inlay is
finished using stone.
5. The temporary inlay is then cemented using
temporary cement.

27. IV. Factors affecting the selection of the
temporary restorations:
1) Type of the final restoration:
 For metallic restorations: zinc-oxide and
eugenol, modified zinc-oxide and eugenol.
 For non-metallic restorations: it may be
wise to use non-eugenol dressing as the
residual eugenol in the dentinal tubules may
hinder the polymerization of the resinous
materials and it will affect the adhesion to
the tooth structure.

28. 1) Vitality of the tooth:
Root canal treated teeth need an intensive
protective dressing, to prevent their fracture
under masticatory load. This might be
attributed to the dehydration of the tooth
structure and its weakening due to
endodontic cavity preparation in addition to
the previous destruction or caries. It is
recommended to use temporary full coverage
in between visits, if the treatment planning is
considering full coverage.

29. 3) Size of the Cavity:
The smaller the size of the cavity, the less
will be the need for more than zinc-oxide and
eugenol dressing. In larger sized cavities we
used reinforced ZOE and temporary resin
restorations.

30. 4) Length of time before permanent restorations:
If less than two weeks, ZOE or soft type
of ready made temporary fillings could be
used. If more than two weeks, reinforced ZOE,
medium and hard type of readymade
temporary filling and temporary resin
restorations are used .

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