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Tips from Our Readers| Volume 114, ISSUE 4, P614-615, October 2015

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Fabricating short-term interim restorations from edentulous tissue conditioner material

Published:June 27, 2015DOI:https://doi.org/10.1016/j.prosdent.2015.01.018
Fabricating short-term interim restorations from edentulous tissue conditioner material
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      The fabrication of interim restorations is a critical step in fixed prosthodontic treatment.
      • Yuodelis R.A.
      • Faucher R.
      Provisional restorations: an integrated approach to periodontics and restorative dentistry.
      Dent Clin North Am. 1980; 24: 285-303
      , 
      • Spoor R.
      Predictable provisionalization: achieving psychological satisfaction, form, and function.
      Pract Proced Aesthet Dent. 2004; 16: 433-440
      In an extensive treatment, creating proper margins and adequate emergence profiles requires time and precision.
      • Rieder C.E.
      Use of provisional restorations to develop and achieve esthetic expectations.
      Int J Periodontics Restorative Dent. 1989; 9: 122-139
      , 
      • Regish K.M.
      • Sharma D.
      • Prithviraj D.R.
      Techniques of fabrication of provisional restoration: an overview.
      Int J Dent. 2011; 2011: 134659
      However, if a rehabilitation appointment needs to be shortened unexpectedly and the relined interim shell still needs to be refined, the use of a short-term interim restoration is convenient for both the patient and clinician. This article describes a technique for fabricating a rapid and esthetic short-term interim device from a tissue conditioner and a vacuum-formed matrix.
      This alternative method comforts patients who are self-conscious and concerned about their dental esthetics during short intermissions such as lunch or lengthy breaks. It can also be used for those who do not tolerate long visits, allowing them to return on the following day so that overnight laboratory adjustments of the interim or of the definitive restorations can be completed. It is a useful and good backup technique for patients with fragile interim restorations likely to fail and is readily available in case of unscheduled emergencies.
      Tissue conditioning material is easy to mix, manipulate, and remove. Furthermore, the substance (Coe-Comfort; GC America) is white and reasonably simulates the natural dentition in the short term. It also covers the prepared teeth and minimizes their sensitivity. Because this material is used traditionally for tissue conditioning, it is biocompatible and not harmful to the gingival tissue. However, it should not be kept in place for more than 1 week because it may depress the interdental papillae when it hardens.
      • Elsemann R.B.
      • Cosme D.C.
      • Souto A.A.
      • da Silva D.F.
      • de Mello J.S.
      • Shinkai R.S.
      Degradation of tissue conditioners in complete dentures: an in situ study.
      Int J Prosthodont. 2008; 21: 486-488

      Procedure

      • 1.
        Complete a diagnostic waxing (Fig. 1), reproducing the requirements of the definitive restoration.
        Figure thumbnail gr1
        Figure 1Diagnostic waxing.
      • 2.
        Duplicate the waxing with a polyvinyl siloxane impression material (Extrude; Kerr Corp).
      • 3.
        Prepare a duplicate cast with Type IV dental stone (UltiRock; Whip Mix Corp).
      • 4.
        Before the preparation appointment, fabricate a vacuum-formed matrix on the duplicate cast
        • Fiasconaro J.E.
        • Sherman H.
        Vacuum-formed prostheses. I. A temporary fixed bridge or splint.
        J Am Dent Assoc. 1968; 76: 74-78
        (Clear Splint Biocryl, 0.75 mm; Great Lakes Orthodontics).
      • 5.
        Trim the device at the gingival margins of the facial surface (Fig. 2) and round any sharp edges with a no. 25 Bard-Parker blade (Aspen Surgical Products). Maintain support available from lingual/palatal tissue areas to provide a vertical stop.
        Figure thumbnail gr2
        Figure 2Vacuum-formed matrix on duplicate cast.
      • 6.
        Mix white tissue conditioner material (Coe-Comfort) according to the manufacturer’s recommendations.
      • 7.
        Cut off the tip of a disposable syringe (Monoject Curved Tip Syringe; Kendall Healthcare).
      • 8.
        Place the mixture in the syringe and load the trimmed matrix (Fig. 3).
        Figure thumbnail gr3
        Figure 3Loading tissue conditioner in trimmed matrix.
      • 9.
        Place the matrix on the prepared teeth.
      • 10.
        Remove excess material intraorally with an explorer and/or a composite resin placement instrument and extraorally with a no. 25 Bard-Parker blade or a tungsten carbide bur mounted on a straight handpiece.
      • 11.
        Allow adequate time for setting before excessive manipulation, and instruct the patient in appropriate care and hygiene measures (Fig. 4).
        Figure thumbnail gr4
        Figure 4Intraoral view of device.

      References

        • Yuodelis R.A.
        • Faucher R.
        Provisional restorations: an integrated approach to periodontics and restorative dentistry.
        Dent Clin North Am. 1980; 24: 285-303
        View in Article
        • Spoor R.
        Predictable provisionalization: achieving psychological satisfaction, form, and function.
        Pract Proced Aesthet Dent. 2004; 16: 433-440
        View in Article
        • Rieder C.E.
        Use of provisional restorations to develop and achieve esthetic expectations.
        Int J Periodontics Restorative Dent. 1989; 9: 122-139
        View in Article
        • Regish K.M.
        • Sharma D.
        • Prithviraj D.R.
        Techniques of fabrication of provisional restoration: an overview.
        Int J Dent. 2011; 2011: 134659
        View in Article
        • Elsemann R.B.
        • Cosme D.C.
        • Souto A.A.
        • da Silva D.F.
        • de Mello J.S.
        • Shinkai R.S.
        Degradation of tissue conditioners in complete dentures: an in situ study.
        Int J Prosthodont. 2008; 21: 486-488
        View in Article
        • Fiasconaro J.E.
        • Sherman H.
        Vacuum-formed prostheses. I. A temporary fixed bridge or splint.
        J Am Dent Assoc. 1968; 76: 74-78
        View in Article

      Article info

      Publication history

      Published online: June 27, 2015

      Identification

      DOI: https://doi.org/10.1016/j.prosdent.2015.01.018

      Copyright

      © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

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