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BURBANK DENTAL LAB / BLOG / Successful Prosthetic Treatments: The Importance of Provisionals

Successful Prosthetic Treatments: The Importance of Provisionals

mm Written by Andrew Sedler / January 20, 2024

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  • Dentures and denture bases
  • Provisionals
  • Occlusal Splints
  • Milled or printed casts
  • Retainers

A prosthetic treatment plan cannot be successful without provisional restorations. Provisional restorations can restore function and aesthetics, protect the pulp, stabilize abutments, and maintain position. Furthermore, they play an essential role in oral rehabilitation cases by simulating the final restoration. These models offer a valuable tool for reorganizing the occlusal scheme in cases involving loss of vertical dimension and complicated oral rehabilitation cases.

A provisional restoration is essential for evaluating aesthetics and phonetics during treatment.

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Provisionalisation

Provisionalisation has played a significant role in achieving success in everything from single units to extensive full-mouth rehabilitation. The introduction of computer-aided design and computer-aided manufacturing (CAD/CAM) fabrication using subtractive manufacturing has greatly improved the following:

  • Impression methods are more efficient
  • Chair time is reduced
  • Clinicians report greater satisfaction
  • Patients report greater overall satisfaction

Traditionally, provisional materials are fabricated with polymers and monomers, which can be tedious and time-consuming. Milling machines have rapidly replaced analog techniques for producing provisionals. In particular, digitally fabricated polymethyl methacrylate (PMMA) provisional restorations provide highly accurate anatomical detail. Axial contours and occlusal anatomy can be digitally designed using the case plan to mimic natural dentition.

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Custom Healing Abutments

Successful Prosthetic Treatments: The Importance of Provisionals - Burbank Dental Lab - California

Polymethyl methacrylate (PMMA) is used primarily for prosthetic applications in dentistry. There are several uses for this material in dentistry, primarily due to its versatility. PMMA is a unique material that offers the following:

  • Highly aesthetic
  • Low density
  • Easy to work with and manipulate
  • Cost-effective option

This highly versatile material can be used for a wide variety of dental applications, including the following:

DuraTemp PMMA

DuraTemp Provisionals - Burbank Dental Lab - Los Angeles - Burbank

Burbank Dental Lab has long understood the importance of provisionalisation in successful dental cases. The impact of a provisional that fits and acts as well as the final restoration, is a key factor in a successful case. The ability to accurately design the provisional is important, but also the accuracy in the milling of the final restoration is paramount to the overall result.

DuraTemp PMMA of Burbank Dental Lab is fabricated provisional restorations are milled high-grade PMMA and milled using the highest precision manufacturing. The fabrication techniques of Burbank Dental Lab are crucial in the accuracy of the provisionals. This is due to the advanced milling systems and the optimal curing conditions of the PMMA. CAD/CAM-generated DuraTemp PMMA provisionals are made from conventional impressions and digital workflows on IOS devices.

These provisionals are recommended for long-term provisional needs like implants or surgical cases. In addition to being more durable than conventional provisionals, they can be made to receive titanium cylinders for the provisionalisation of screw-retained implants. For screw-retained cases, a duplicate PMMA DuraTemp can be requested so the original can be sent to the lab to replicate any adjustments made after the patient has worn it for a period of time.

Benefits of DuraTemp Provisionals

DuraTemp provisionals are not only more durable, but they are also more aesthetic and natural looking than chair-side provisionals. DuraTemps rival the finished restorations. They are effectively a prototype of what their final restorations will look and function like. This eliminates the possibility of any surprises at the final seat date, greatly improving patient satisfaction.

Custom Healing Abutment - Burbank Dental Lab - Burbank, CA

Below are some of the benefits of DuraTemps:

  • They can be used for either single units or multi-unit cases.
  • They are an ideal solution when the case requires the vertical dimension of occlusion (VDO) to be altered. The ideal VDO can be determined prior to preparing any teeth.
  • They offer an excellent option for immediate extraction cases by helping to create the ideal pontic shape.
  • DuraTemps can be fabricated either before preparation or after preparation.
  • They can be used to pre-approve the contours, shade, and length. This information will then be used as a guideline for the final restorations.

Allowing Burbank Dental Lab to fabricate the provisionals can save significant chair time.

DuraTemp Workflow for A Multi-Unit Case

Successful Prosthetic Treatments: The Importance of Provisionals - Burbank Dental Lab - California
Figure 3

Burbank Dental Lab supports a complete digital workflow for doctors restoring multi-unit implant-supported fixed prosthesis cases that need a DuraTemp Provisional. The steps are as follows:

  1. The patient’s existing dentition must be retained to locate the midline and place the final teeth correctly. A study model or an existing denture can be used.
  2. Scan bodies are used to mark the implant sites and scanned using an IOS scanner or even an extraoral scanner such as the ICAM4D scanner. This will mark the orientation and position of the implants. (Figure 3)
  3. An intraoral scanner should be used to scan the soft tissue.
  4. In the laboratory, the digital data from these scans are combined to form an exact dental model. (Figure 4)
  5. The DuraTemp PMMA provisional can be created. (Figure 5)
  6. Obtain feedback from patients regarding the provisional plan.
  7. Finalize the implant-supported fixed prosthesis by incorporating the patient’s comments.
Successful Prosthetic Treatments: The Importance of Provisionals - Burbank Dental Lab - California
Figure 4
Successful Prosthetic Treatments: The Importance of Provisionals - Burbank Dental Lab - California
Figure 5
How To Avoid A Dental Prosthesis Remake Due To Fit - by Vincent Nalbandian, Implant Department Manager

DuraTemp Insertion

  • Ensure passive seating works and that the occlusion and vertical are accurate by trying in DuraTemp provisionals.
  • After try-in, clean the restorations with water and dry them.
  • Cold-cure acrylic can be used to reline. Relining requires blocking out any undercuts on the preps.
  • Remove excess acrylic from the margins.
  • Utilize a light-cured glaze, such as Palaseal, after polishing restorations with pumice and acrylic polishing paste.
  • The temporary cement should be non-eugenol.

There are several different workflow options available for handling cases. This is especially true when working in larger, more complex cases. Using an effective provisional is a key factor in ensuring these types of cases offer a predictable outcome.

With a DuraTemp provisional, the patient understands the final restoration, and there are no surprises. This provides an excellent opportunity to offer an exceptional level of patient satisfaction.

Allow Burbank Dental Lab to help set up a complete case plan and workflow method for your next case. Our trained staff ensures that your case flows smoothly from beginning to end. For help with your next implant-supported hybrid prosthesis, click the blue icon in the corner or call us at (800) 336-3053.

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