FIXED PROSTHODONTICS: SINGLE TOOTH CASTINGS Page 1 Lecture: "Temporary/Provisional Materials"
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1 FIXED PROSTHODONTICS: SINGLE TOOTH CASTINGS Page 1 Lecture: "Temporary/Provisional Materials" OVERVIEW: A. Introduction: 1. Definitions a. Temporary = Provisional = Non-Permanent = 2-26 weeks (1) Short-term = 2-6 weeks (2) Long-term = 6-26 weeks b. Temporary System = restorations + cement 2. Temporary crown fabrication procedures: a. Direct -- intraoral fabrication (and intraoral/extraoral curing) [0s= mix and add to pre-impression; 45s= insert in mouth; 1m= initial set; 2m= remove; 6m= trim; 7m=contour and polish; 12m=cement in mouth] b. Indirect -- extraoral or laboratory fabrication B. General Goals and Desirable Properties for Resin-based Restorations: 1. Manipulation goals: a. Clinical concerns: ease-of-use; versatility; low cost; easy to repair b. Reaction: Fast; low polymerization exotherm; high percent conversion c. Minimal surface reactions: O2 inhibition on curing; no interactions with impression material (e.g., PVS) causing surface inhibition 2. Physiologic goals: a. Protection of hard and soft tissues; stabilization of tooth; functional for chewing; b. Therapeutic (indirect pulpal medication); patient comfort 3. Materials performance goals: a. Good esthetics: good color matching; stain resistance (to coffee and tea) b. Good fracture and wear resistance c. Good biocompatibility -- no sensitivity reactions 4. Post-temporization goals: no interference with cements for permanent restoration C. Classification: 1. Provisional restorations a. Intracoronal Restorations: (1) ZOE-based and/or ZONE-based temporaries b. Preformed Provisional Shell Crowns (and Cements): (1) Polycarbonate Crowns (2) Metal Alloy Crowns (Al, Anodized Al, Sn-Ag, Stainless Steel, Ni-Cr) c. Custom-Fabricated Provisional Crowns (and Cements): (1) MMA-like products (MMA/PMMA, IBMA/PBMA, EMA/PEMA) self-cure (2) Epimine-imine products self-cure (3) Bis-acryl, bis-methacryl, Bis-GMA-like self-cure, dual cure, VLC (a) Resins (b) Composites 2. Temporary cements: a. ZOE-based or ZNOE-based cements: b. Calcium hydroxide cements c. "Admix cements" (Cements mixed with vaseline or petroleum jelly) d. Composite cements (without bonding systems)
2 Dental Materials "Temporary / Provisional Materials" Page 2 PRODUCTS A. Provisional Restorative Materials -- Resin/Composite (HC= heat-cured; CC= chemically-cured; DC= dual-cured; LC or VLC= visible light-cured) 1. Reinforced ZOE and ZONE: IRM (Caulk) CC ZOE Tempocem (DMG Hamburg) CC ZOE 2. Tempocem NE (DMG Hamburg) CC Zinc Oxide / Non-Eugenol Liquid MMA-like products: Jet (Lang Dental Mfg Co) CC MMA/PMMA Trim, TRIM II (Bosworth) CC Isobuty methacrylate(ibma)/pbma Temporary Bridge Resin (LD Caulk) CC MMA/PMMA SR-Ivocron-PE (Ivoclar) HC MMA/PMMA Alike (GC America) CC MMA/PMMA Unifast (GC America) CC MMA/PMMA Duralay (Reliance Dental) CC MMA/PMMA Ceri-Temp (Denmat) CC MMA/PMMA Coldpac (Multoid) CC MMA/PMMA Snap (Parkell) CC EMA/PEMA 3. Splintline (Lang Dental) CC EMA/PEMA Epimine imine resin products: 4. Scutan (ESPE) CC Epimine resin Bis-acryl resin products: Protemp (ESPE) -- discontinued CC Bis-acryl 5. Ultra-Trim (Bosworth) CC Bis-acryl Composite resin products: TempCare (3M) - discontinued LC Composite Fermit and Fermit N (Ivoclar) LC Composite Luxatemp (DMG Hamburg) - handmix,solar, auto CC Composite Luxatemp Solar (DMG Hamburg) DC Composite Protemp Garant (ESPE) CC Bis-acryl composite Protemp II (ESPE) CC Bis-acryl composite Provipont DC (Ivoclar/Vivadent) DC Composite Triad VLC (Dentsply) LC Bis-acryl composite IsoTemp (3M) CC Ethoxylated BisGMA Composite Pro-Fitt (Lone Star Technologies) SC Bis-acryl composite SmarTemp (Parkell) SC Bis-acryl composite Temphase (Kerr) SC Bis-acryl composite Bis-Jet (Lang Dental) SC Bis-acryl composite Provise (GC America) SC Bis-acryl composite FlexSpan (Jeneric Pentron) SC Bis-acryl composite Integrity (Dentsply) SC Bis-acryl composite B. Temporary Cements: 1. ZOE cements: TempoCem NE (DMG Hamburg) CC ZnO / Fatty Acids Tempbond (Kerr) CC Reinforeced ZOE 2. ZOE B+T CC Reinforced ZOE Calcium hydroxide cements: Dycal (Caulk) CC Calcium hydroxide 3. Reocap Temp IC (Vivadent) "Admix" cements: CC Calcium hydroxide 4. Composite cements: Tempbond Clear (Kerr) CC Urethane diacrylate comp Provilink (Vivadent) LC Composite
3 Dental Materials "Temporary / Provisional Materials" Page 3 C. Popularity (Personal Communication, Ed Shellard, 1999) Methyl & Ethyl Methacrylates 12% Dual-Cure Composite Resins 4% Parkell Snap 5% Bosworth Trim 5% Other All Types 10% DMG/Zenith Luxatemp 25% Kerr Temphase 8% Self-Cure Composite Resins 84% Caulk Integrity 15% ESPE Protemp 32% PROPERTIES A. Examples of Physical, Chemical, and Mechanical Properties: Iso-Temp (3M) Luxatemp AutoMix (DMG) Prodigy Composite (Kerr) Z100 Composite (3M) Type Temporary Temporary Permanent Permanent Cure CC DC VLC VLC Cure Time 6-7 m % Shrinkage T 38 C CS (MPa) DTS (MPa) FS (MPa) BFS (MPa) Flexure Strength (MPa) Trim Trim Snap Snap Protemp Protemp Temphase Temphase Fast Fast Set Set Temphase Temphase Reg. Reg. Set Set Luxatemp Luxatemp Iso-Temp Iso-Temp Integrity Integrity Compressive Strength (MPa) Trim Trim Snap Snap Protemp Protemp Temphase Temphase Fast Fast Set Set Temphase Temphase Reg. Reg. Set Set Luxatemp Luxatemp Iso-Temp Iso-Temp Integrity Integrity
4 Dental Materials "Temporary / Provisional Materials" Page 4 EXAMPLES:
5 Dental Materials "Temporary / Provisional Materials" Page 5
6 Dental Materials "Temporary / Provisional Materials" Page 6 MULTIPLE CHOICE STUDY QUESTIONS: 1. What is the overall longevity range for most provisional restorations: a. 1-2 weeks b. 2-6 weeks c weeks d weeks e weeks 2. What is the initial setting time for acrylic provisional crown materials? a sec b. 1-2 min c. 4-5 min d. 6-8 min e min 3. What category of temporary crown materials is normally used for adult anterior tooth preparations? a. Polycarbonate crowns b. Metal crowns c. Acrylic custom-fabricated crowns d. Bis-Acryl custom-fabricated crowns e. ZOE-based crowns 4. Which one of the following temporary restoration materials does not involve freeradical chemistry: a. Bis-acryl b. MMA c. ZOE d. Composite e. BMA 5. Which of the following temporary restorations is the LEAST IRRITATING to patients? a. Bis-acryl b. MMA c. Epimine d. BMA e. ZOE 6. Which of the following is NOT a key requirement for provisional temporary restorations? a. High compressive strength b. Low polymerization exotherm c. Good surface finish d. High toughness e. Good wear resistance 7. Which of the following materials does NOT inhibit free radical polymerizations? a. Polyether impression material b. Polyvinyl siloxane impression material c. Eugenol d. Oxygen e. Latex glove powder
7 Dental Materials "Temporary / Provisional Materials" Page 7 8. The main ingredient in traditional acrylic resin temporary materials for intraoral fabrication is: a. Butyl Methacrylate b. Isobutyl Methacrylate c. BISGMA d. Ethylene Imine e. Methyl Methacrylate 9. Which one of the following materials involves the lowest polymerization exotherm? a. Trim b. Scutan c. IRM d. Jet e. Protemp Garant 10. Which of the followinng is NOT true of "JET" temporary material? a. Should be set directly in the mouth b. Produces more shrinkage than Protemp Garant c. Has relatively low mechanical strength d. Has excellent stain resistance e. Is relatively inexpensive 11. Which of the following materials is NOT a composite provisional material? a. Protemp II b. Luxatemp c. Temporary Bridge Resin d. Provipont e. Integrity 12. Which of the following is NOT a temporary dental cement product? a. Tempbond b. Integrity c. ZOE B+T d. Dycal e. TempoCem NE , Stephen C. Bayne, Chapel Hill, NC 27514
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