acrylic resin autopolymerizing resin exotherm external surface form (ESF)
poly(methylmethacrylate) poly(R' methacrylate) provisional luting agent tissue surface form (TSF)
Provisional crowns or fixed partial dentures are essential to prosthodontic therapy. The word provisional means established for the time being, pending a permanent arrangement. Even though a definitive restoration may be placed as quickly as 2 weeks after tooth preparation, the provisional restoration must satisfy important needs of the patient and dentist. Unfortunately, temporary usually connotes laxity, and this may imply that requirements pertaining to the more permanent condition are ignored. If this connotation becomes a philosophy governing the provisional phase of treatment, the dentist will needlessly be reducing clinical efficiency and treatment quality. Experience has repeatedly shown that the time and effort expended in fulfilling the requisites of provisional restorations are well spent.
Because of unforeseen events (e.g., laboratory delays or patient unavailability), a provisional restoration may have to function for an extended period. On the other hand, a delay in placing the definitive restoration may be deliberate (e.g., because the etio-logic factors of a temporomandibular disorder or periodontal disease must be corrected). Whatever the intended length of time of treatment, a provisional will have to be adequate to maintain patient health. Thus it should not be casually fabricated on the basis of expected short-term use.
Provisional procedures also must be efficiently performed, because they are done while the patient is in the operatory and during the same appointment that the teeth are prepared. Costly chairside time should be used efficiently with the practitioner producing an acceptable restoration. Failure to do so will result in the eventual loss of more time than was initially thought saved. For example, an inadequate restoration may lead to unnecessary repairs or to the need to treat gingival inflammation and remake the impression. Such problems can be avoided if one thoroughly understands what is required of the provisional and makes the effort to meet these requirements.
An optimum provisional restoration must satisfy many interrelated factors, which can be classified as biologic, mechanical, and esthetic (Fig. 15-1).
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