We all strive to make our provisionals fit as well as we can. Improved fit of our provisional restorations reduces tooth sensitivity and increases tissue health, thereby leading to a more efficient delivery of the definitive restoration. Today, the most common material used to fabricate provisional restorations is a Bis-acryl composite. If you use this type of material, one easy step to help improve the marginal fit of your provisional restorations is to physically remove the air-inhibited layer that develops on the "internal" of the provisional.

For years my protocol for trimming a provisional restoration has been to first clean the provisional in alcohol prior to starting the adjustment process. This helps to remove the air-inhibited layer and make the adjustment process more efficient without clogging up the bur. After completing the adjustment of the provisional with burs and disks, I would air abrade the internal of the provisional with a sandblaster.

This process helped me achieve a very nice marginal fit. However, I believe the fit of my provisionals is now even better. What I have started to do to help improve the fit of my provisional restorations is to manually scrape the internal of the provisional with a hand instrument prior to air abrasion.

As you can see by the photo, this additional step removed a fairly significant amount of material that is not fully cured and isn't removed by air abrasion. Removing this material with a hand instrument enables a more "passive" and complete seat of the provisional restoration on the tooth, thereby leading to a better fit. Try this on your next provisional restoration and you too will see how it will help improve the marginal fit.



Comments

Commenter's Profile Image Tyler Williams DDS
November 2nd, 2013
can't wait to try it!
Commenter's Profile Image John Smith
November 2nd, 2013
How do you measure the fitness of the temp? In another word, how can you tell that it fits better just by scraping the internal aspect of the temp?
Commenter's Profile Image Arnie Mirza
November 3rd, 2013
Thank you Greg for this nice info.
Commenter's Profile Image Mike Radcliffe
November 29th, 2013
I am with John Smith from above-this removal could lead to 'sloppy play" in the fit even though the margin may be sealed; the sand plast and alcohol works well enough I feel, but thanks for the optional step if things are not seating well.
Commenter's Profile Image DR Derry Rogers
December 27th, 2013
Returning to the old days of vented PFM,s.......... If you create a vent hole in the occlusal surface, at seating the excess provisional cement extrudes providing a better marginal seat. You can always clean up the provisional composite cement and overlay the hoke with flow able composite and cure Also accelerates the set of temp cements with a composite base such as Tempbond clear.
Commenter's Profile Image Muna Strasser
January 10th, 2014
I have found this to be a useful tool- thanks for posting!