The route to aesthetic perfection

Temporary crowns have numerous duties during the process of a fixed restoration

Temporary crowns perform numerous biological, functional and aesthetic duties on an intermediate basis during the process of producing a fixed restoration. Our patients’ demands regarding the quality of their prosthetic restorations are constantly increasing. They are therefore placing ever-greater value not only on the re-establishment of the function but also on the appearance of their smile.

An immaculate, gleaming white smile is an expression of profess-ional and social success. Even a change to a single tooth, the insertion of a single crown, can have a considerable influence on the overall appearance of the patient. In a positive as well as a negative manner the patient’s appearance can be influenced. In order to define the expectations of the patient as accurately as possible, and to be able to meet them, the use of temporary restorations has proven significant, not only for the protection of prepared teeth, but also for the simulation of the desired treatment results.

Temporaries are playing an increasingly important role in dentist-patient communication. In this way, temporary restorations are suitable as a simple and visual means through which to communicate with the patient about the design and subsequent appearance of the new dental prosthesis.

Materials used

On the basis of a clinical case, the use of StatusBlue, Luxatemp Star, LuxaFlow Star and Luxatemp-Glaze&Bond is explained. It illustrates step-by-step the making of a direct temporary. StatusBlue is a medium-bodied VPS material, which is used to produce the situation model. Luxatemp Star is a two- component material based on multifunctional methacrylates. It serves as a temporary material.

The Luxatemp Star family is completed by the Bis-GMA composite, LuxaFlow Star, which is used for shape adjustment and customisation of temporary crowns. Luxatemp-Glaze&Bond is a one-component material based on multifunctional methacrylates. It is used for glazing the temporary surface and can also be used as a bonding agent between the different resins.

Case report

A 64-year-old male patient booked an appointment with our clinic because he was unhappy with the aesthetics and, in particular, the colour of tooth 44 (Figure 1). Tooth 44 had received a crown a few years previously due to an existing extended cavity. For aesthetic reasons the patient desired a new zirconium dioxide-based all-ceramic restoration. The prepared tooth was provisionally restored using a temporary restoration fabricated chairside from Luxatemp Star.

Prior to starting preparation, an impression of the initial situation was taken. For this purpose a conventional Rimlock tray was coated with tray adhesive from DMG (Fig 2) in order to be able to guarantee the optimum hold between the tray and impression material during subsequent use. The impression material was mixed homogenously and quickly using the DMG mixing device MixStar-eMotion and was loaded into the tray free of bubbles (Fig 3). The impressions obtained in this way (Fig 4) were used as a matrix for the production of the temporary.

The preparation of tooth 44 for an all-ceramic crown took place subsequently (Fig 5). After checking for undercut areas, the preparation was lightly isolated with Vaseline. The impression produced with StatusBlue was now filled with Luxatemp Star (Fig 6) and the tray was subsequently repositioned in the patient’s mouth. The material conveniently allows 45 seconds for this step, before it begins to harden. During the elastic phase of the temporary material, which spans the period between one minute 30 seconds and two mins 30 secs, the impression must be taken out of the patient’s mouth. The temporary reaches final hardness after five mins. After removing the temporary from the impression (Fig 7) the excess was cut away and the temporary was placed on the tooth to check the fit. Following this, the final refinement took place extraorally using burs and rubber polishers (Fig 8).

Final colour adjustments were carried out using LuxaFlow Star (Figs 9 and 10) and the surface was then coated with Luxatemp-Glaze&Bond and light cured (Figs 11 and 12). For cementation, the temporary was filled with DMG’s TempoCemNE (Fig 13) and placed on the prepared tooth. After the temporary cement had hardened the excess was removed with a probe (Fig 14).

Temporary restorations produced in this way constitute an aesthetically and functionally entirely satisfactory temporary replacement (Fig 15).

Conclusion

With the aid of simple techniques it is possible to achieve a highly satisfactory aesthetic result for the patient. The temporary crown can serve in this regard as an effective aid to dentist-patient communication. It is thereby possible to imitate the desired result and provide the patient with an initial, realistic impression of the subsequent permanent restoration. On this basis, corrections can be agreed in terms of shape and colour, which are simple to implement at any time during the period in which the temporary is worn, and which can then be transferred to the permanent restoration.

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The complete LuxaTemp Star family is distributed in the UK and Ireland by DMG Dental Products (UK) Ltd. For further information, contact your local dealer or DMG Dental Products (UK) LTD on 01656 360100, email info@dmg-dental.co.uk or visit www.dmg-dental.com

All medical images can be found in the online magazine at the top of the homepage.

Published: 21 March, 2011 at 11:06