Interim Fixed Restorations

Dr. Diaaeldin Saad Awad

BDS, MSc, PhD
Associate professor of prosthodontics
Gulf Medical University
 The objectives of the lecture
❑ Identify the importance of properly designed interim
restoration.

❑ Enumerate the ideal requirements of interim restorations

 The contents
❑ Definition.
❑ Classifications
❑ Requirements of Interim Restoration.
❖ Biologic - Mechanical - Esthetic.
❑ The characteristics of an ideal interim material.
❑ Available materials for Interim restorations.
 Interim Restorations

Provisional = Temporary = Interim

 Definition
❑ Temporary restoration: used temporarily for the protection of
prepared teeth, till the cementation of bridge is completed.

❑ Provisional restoration: It is a temporary protective crown or

bridge that is cemented temporarily to a tooth that has been
prepared to receive a single crown or for abutment teeth to
receive a fixed bridge. (Time: 2 weeks to 1 month)
 Definition

❑ Interim restoration: Interim means established for the time

being, pending a permanent arrangement.
Requirements of Interim Restoration
 Biologic requirements
Protecting the pulp

Isolating materials Good marginal integrity

Prevent sensitivity and Leakage can cause
further irritation to the pulp irreversible pulpitis

If not RCT
 Maintain periodontal health

No compressing
(papilla)
No overhang

Good marginal fitting

Proper contour
Smooth Surface

Biologic requirements
 Biologic requirements
If not Inflamed or hemorrhagic
gingival tissues

make subsequent procedures

(e.g., impression making and
cementation) very difficult.
Biologic requirements
When gingival tissue is impinged
upon, ischemia is likely to develop.
This can be detected initially as
tissue blanching.

If it is not corrected, a localized

inflammation or necrosis develops.
 Biologic requirements

Overcontouring: The transition from the restoration to the root surface is

irregular, and marginal adaptation is inadequate. These contribute to
plaque accumulation and an unhealthy periodontium.
 Biologic requirements
Occlusal compatibility and tooth position

The interim fixed restoration should maintain proper contacts

with adjacent and opposing teeth.
 supraeruption and horizontal
If not movement

Additional treatment will be

necessary

Biologic requirements
Prevention of enamel fracture

Specially partial coverage designs in which

the margin of the preparation is close to the
occlusal surface

Biologic requirements
 Biologic requirements

Prevention of enamel fracture

 Mechanical requirements
❑ Resist functional loads.
❑ Resist displacement forces.
❑ Removal for reuse.
 Mechanical requirements

Resist Functional loads

The strength of polymethyl methacrylate resin is about one-

twentieth (1/20) that of metal-ceramic alloys
 Mechanical requirements

This acrylic interim crown fractured. The interocclusal record between the
preparation and its antagonist shows that the preparation was underreduced
Mechanical requirements
❑ Occlusal forces are transmitted to the abutments. This creates high
stresses in the connectors, which are commonly the sites of failure.
❑ To reduce the risk of failure, connector size must be increased in
the interim restoration in comparison with the definitive restoration.
Mechanical requirements
❖ In the anterior region, the degree of
overcontouring is substantially limited
by esthetic requirements.
❖ In the posterior region, esthetics is less
restrictive, but overcontouring still must
not jeopardize the maintenance of
periodontal health.
 Mechanical requirements
Indications of fiber-reinforced, heat-processed
resin
 Mechanical requirements

Resist displacement forces

Displacement is best prevented through proper tooth

preparation and an interim restoration with a closely
adapted internal surface.

Excessive space between the restoration and the tooth places greater demands on the luting
agent, which has lower strength than regular cement and thus cannot tolerate the added
force. For this and for biologic reasons, unlined preformed crowns should be avoided.
 Mechanical requirements

Removal for reuse

Interim restorations often need to be reused and so

should not be damaged when removed from the teeth
 Esthetic requirements
❑ Has good and smooth contour.
❑ Color compatible.
❑ Be translucent.
❑ Be color stable.
Criteria for good provisional restoration
❑ Must be esthetically acceptable to the patient.
❑ The contours are similar to those of the natural tooth.
❑ The cervical margin is smooth and fits snugly.
❑ Does not extend below the margin of the preparation.
❑ The occlusal surface is aligned with the occlusal plane of the
adjacent teeth.
❑ When cemented, it remains stable, stays in place, and is
comfortable for the patient.
❑ Can be readily removed without damage to the tooth or adjacent
tissues.
The characteristics of an ideal interim material are as follows:
❑ Convenient handling: adequate working time, easy molding,
rapid setting time.
❑ Biocompatibility: nontoxic, nonallergenic, nonexothermic.
❑ Dimensional stability during solidification.
❑ Ease of contouring and polishing.
The characteristics of an ideal interim material are as follows:
❑ Adequate strength and abrasion resistance.
❑ Good appearance: translucent, color controllable, color stable.
❑ Good acceptability to patient: nonirritating, odorless.
❑ Ease of adding to or repairing.
❑ Chemical compatibility with interim luting agents.
Currently Available Materials
❑ Poly methyl methacrylate.
❑ Poly ethyl or isobutyl methacrylate.
❑ Microfilled composite.
❑ Light cured resins.
Currently Available Materials
❑ A major problem: dimensional change during solidification.
❑ These materials shrink and cause marginal discrepancy,
especially when the direct technique is used. Also, the resins
currently employed are exothermic and not entirely
biocompatible.
❑ List at least five requirements for the success of an interim
restoration?

❑ What are the currently available materials for fabrication of

interim restorations?
 References

Contemporary fixed prosthodontics.

5th Ed (Chapter 15)
Thank You