Triad Provisional Material (Dentsply) has been an extremely useful and versatile material in many dental practices and in our campus workshops. The light-cured, resin-based material was known for its color stability, polishability and relative ease of manipulation. Unfortunately, earlier this year production of this material was cancelled and it is no longer available from the manufacturer.
To be clear, there are still many different Triad materials available, including the clear tray material. While that’s good news, it still leaves clinicians with the problem of replacing the provisional material.
One area where this material has been extremely useful is in the construction of anterior bite planes. The fabrication process utilizes a relatively rigid thermoplastic base (Splint Biocryl 1.5 mm, Great Lakes Ortho) with a flat anterior portion that is customized for the patient's occlusion and fabricated from Triad provisional material. This fabrication process is efficient and relatively easy to complete in the office.
Possible solutions for Triad Provisional Material replacement
One obvious solution to this problem is to delegate fabrication to the dental laboratory and let the technician work around the material problem. The major disadvantage to this option is the amount of time required to get the case to and from the lab, essentially cancelling one of the key benefits of this appliance’s design.
Another possible solution, for those with in-office milling, is to digitally design and fabricate the appliance. Dr. Kevin Kwiecien discusses the pros and cons of this method using CEREC in an article on going digital with the anterior bite plane.
A third possibility is to go back to the material used previously for these appliances. In this case, it was powder and liquid PMMA. PMMA is available in a variety of colors, including tooth-colored and clear. PMMA wears well, is easily adjusted and polished, and is relatively inexpensive. The major disadvantage to PMMA is its handling characteristics. Since the material is self-cured, working time is limited. Still, acrylic can be a great option.
What material are we using?
For both our campus workshops and our faculty practice, rather than go back to acrylic/PMMA, Great Lakes Ortho has helped source an alternative material from Scheu (scheu-dental.com). The material, Durasplint LC, is a clear, light-cured putty. The handling characteristics are similar to the Triad Provisional Material and the material may be bonded to the Biocryl exactly the same way.
Durasplint LC is easy handling and solves the problem of losing Triad provisional as far as our anterior bite planes are concerned. Since we have only just begun using this material, it’s probably too early to speculate on its durability, yet what we’ve seen up to this point is definitely positive.
We’d love to know what materials you guys are using. Be sure to let us know in the comments section here or over on Spear TALK! You can also learn more about occlusion and appliances here.
(Click the link for more dentistry articles by Dr. Darin Dichter.)
Darin Dichter, D.M.D., Spear Faculty and Contributing Author