Interim Fixed Restorations

Dr. Diaaeldin Saad Awad

BDS, MSc, PhD
Associate professor of prosthodontics
Gulf Medical University
 The objectives of the lecture
❑ Differentiate between the 2 terms external surface form &
internal surface form during interim restoration
fabrication.

❑ Explain the different techniques to obtain the external

surface form.
 The contents
❑ External Surface Form.
❖ Custom ESF - Performed ESF.
❑ Tissue Surface Form.
❖ Indirect Technique.
❖ Direct Technique.
❖ Indirect-Direct Technique.
 Materials and Procedures
❑ All the procedures have in common the formation of a mold
cavity into which a plastic material is poured or packed.
❑ The mold cavity is created by two correlated parts.
External surface form (ESF): forming the external contour of
the crown or FDP.
Tissue surface form (TSF): forming the prepared tooth surfaces
and (when present) the edentulous ridge contact area.

External Surface form (ESF)

Tissue surface form (TSF)

 ESF (External Surface Form)
❑ There are two general categories of ESFs according to
fabrication technique:

Custom Preformed
• Silicon Index. • Polycarbonate.
• Alginate Impression. • Cellulose acetate.
• Thermoplastic sheet. • Aluminum.
• Tin-silver.
• Nickel-chromium.
Custom ESF (External Surface Form)

Alginate impression Putty silicon impression Vacuum formed plastic

shell
 Custom ESF
❑ A custom ESF is a negative reproduction of either the patient's
teeth before preparation or a modified diagnostic cast.
Impression material:

Silicone Irreversible hydrocolloid

Custom ESF
Impression material:
The moldable putty materials are popular because:
❖ They can be used without a tray.
❖ Easily trimmed to minimum size with a sharp knife.
❖ Their flexibility facilitates subsequent removal of the
polymerized resin.
Custom ESF
Thermoplastic transparent sheets:
Transparent sheets are available in cellulose acetate or
polypropylene of various sizes and thicknesses a 125 x 125 mm
sheet of 0.5-mm thick.
Custom ESF
Thermoplastic transparent sheets:
•Advantages:
❖ Transparent form with thin walls.
❖ Minimum interference with the occlusion.
❖ Little additional effort is required to adjust the occlusal contacts.

•Disadvantages:
a Poor dissipater of the heat released during resin polymerization, and
so care must be taken to remove it from the mouth before injury can
occur.
 Custom ESF
Thermoplastic transparent sheets:

Thermoplastic sheets, which are

heated and adapted to a stone cast
with vacuum or air pressure while
the material is still pliable
 Custom ESF
Thermoplastic transparent sheets:
 Custom ESF
Thermoplastic transparent sheets:
 Custom ESF
Thermoplastic transparent sheets:

❖ As the resin sheet is heated to the proper temperature, it will droop or sag
about 1.0 inch in the frame.
Custom ESF

Thermoplastic transparent sheets:

 Performed ESF
❑ They rarely satisfy the requirements of an interim restoration.
❑ must be lined with autopolymerizing resin.
❑ Preformed crowns are generally limited to use as single restorations.
 Performed ESF
❑ Most crown forms need some modification (internal relief, axial
recontouring, occlusal adjustment) in addition to the lining
procedure.
❑ When extensive modification is required, a custom ESF is superior
because it is less time consuming.
 Performed ESF

Polycarbonate crowns:
❑ Has the most natural appearance of
all the preformed materials.
❑ Polycarbonate ESFs are supplied in
incisor, canine, and premolar tooth
types.
❑ Available in only a single shade, this
can be modified to a limited extent
by the shade of the lining resin.
Performed ESF
 Performed ESF
Polycarbonate crowns:
 Performed ESF
Polycarbonate crowns:
 Performed ESF
Polycarbonate crowns:
 Performed ESF

Polycarbonate crowns:
 Performed ESF

Polycarbonate crowns:
 Performed ESF

Polycarbonate crowns:
Performed ESF
Polycarbonate crowns:
Performed ESF
Polycarbonate crowns:
Performed ESF
Polycarbonate crowns:
Performed ESF
Polycarbonate crowns:
Performed ESF
Polycarbonate crowns:
Performed ESF
Polycarbonate crowns:
 Performed ESF
Cellulose acetate:
❑ Is a thin (0.2- to 0.3-mm) transparent
material available in all tooth types
and a range of sizes.
❑ Shades are entirely dependent on the
autopolymerizing resin.
❑ Resin does not chemically or
mechanically bond to the inside
surface of the shell.
Performed ESF
Cellulose acetate:
❑ Removing the shell has the disadvantage of necessitating the
addition of resin to reestablish proximal contacts.
 Performed ESF
Aluminum and tin-silver:
❑ Are suitable for posterior teeth.
❑ Have anatomically shaped occlusal and axial surfaces.
❑ The most basic and least expensive forms are merely
cylindrical shells resembling a tin can.
Performed ESF
Aluminum and tin-silver:
 Performed ESF
Aluminum and tin-silver:
 Performed ESF
Aluminum and tin-silver:
 Performed ESF
Aluminum and tin-silver:
Performed ESF
Aluminum and tin-silver:
Performed ESF
Aluminum and tin-silver:
Performed ESF
Aluminum and tin-silver:
Performed ESF
Aluminum and tin-silver:
 Performed ESF
Non anatomic aluminum cylindrical shells:

❑ Are inexpensive but require

modification to achieve acceptable
occlusal and axial surfaces.
Performed ESF
Nickel-chromium shells: (Stainless Steel)
❑ Are used primarily for children
with extensively damaged primary
teeth.
❑ They are not lined with resin but
are trimmed, adapted with 2
contouring pliers, and luted with a
high-strength cement.
❑ Nickel-chromium alloy is very
hard and thus can be used for
longer-term interim restorations.
TSF (Tissue Surface Form)
Tissue Surface Form
(TSF)

Indirect-
Direct Indirect direct
technique technique technique
Quiz
❑ Differentiate between external surface form & internal surface
form?

❑ What are the techniques that is used to obtain an external surface

form for an interim restoration?
 References

Contemporary fixed prosthodontics.

5th Ed (Chapter 15)
Thank You