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Provisional Crowns Made Simple

I recently had a request from a reader to go into further detail on my technique for fabricating provisional crowns.  Let’s do it!

A patient presents with recurrent decay under a mesio-occlusal porcelain inlay on tooth # 31.  There is also a large buccal amalgam restoration, so the tooth was treatment planned for a full-coverage crown.

#31 planned for full-coverage crown

While I’m waiting for my anesthesia to take effect, I take an impression of the tooth before it has been prepared.  I use alginate in a quadrant tray for a single tooth.

Alginate in a quadrant tray, pre-operatively

If the tooth is going to be in a provisional for a long time, I would use a material like Template instead of alginate.  I can keep the Template matrix in a  safe place for months if I need to fabricate a new one.  Alginate, on the other hand, would distort to the point of being useless after one day.

Now have fun and prepare the tooth.

Okay, provisional time.  I use bis-acryl most of the time.  For a full discussion of this material, check out this post.

I recommend re-seating the tray in the mouth just to ensure it can be easily placed all the way down.  Squirt the first bit of bis-acryl onto the tray and the rest in the matrix for tooth #31 up to the brim.


Now I wait until the little bit of bis-acryl on the tray is set.  Remove the tray and check the fit in the mouth.  Do not evaluate the bite just yet- the material is not fully set and may break.  I’m just evaluating the marginal fit.  Trim the excess with a diamond bur.

Diamonds are your best friend with bis-acryl

Almost done!  Now you can check the occlusion and cement with your favorite temporary cement.

That'll do. That'll do.

This is a pretty simple technique.  Most of my early challenges were due to not being familiar with the differences between bis-acryl and regular acrylic.  Again, check out this post to learn more and save yourself some headaches.


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