 Hello everyone, welcome back to another session of Dentistry and more. So we have a new topic from Fixed Partial Dentures that is Temporization or Provisional Restoration. It is a restoration we keep until a permanent restoration received to the Avertment tooth. Because the tooth we prepared for to receive the retainer will be of compromised quality in aesthetics in its mechanical function. So we need to protect the tooth and provide a good aesthetics. So for those mainly for those reasons we are giving Temporization because if it is an anterior tooth we need to give a Temporization or a Provisional Restoration mainly for the aesthetic purpose. If it is for posterior tooth preparation we need to save the tooth until the final permanent restoration of the permanent crown comes because if it is not given the chances of fracture of the prepared Avertment tooth or there is chance of slight movement. So that will disrupt the fixation process. So to avoid that we give a Temporization or a Provisional Restoration which will be removed while pleasing the permanent one. So the definition of Temporization or Provisional Restoration is a fixed or removal processes designed to enhance aesthetic stabilization and function for a limited period of time after which it is to be replaced by definitive processes. So it has got a few other names interim processes because it is for a very short period. interim processes then we can also call as Provisional processes. So as I said it is basically given for a short period until the permanent restoration is done okay also to protect the prepared tooth and keep keeping the patient comfortable. So by successful treatment with this Provisional Restoration dentist can get the patient's confidence which is a very influencing factor for the success of the final restoration. So what are the basic requirements for Temporization or a Provisional Restoration? We have three categories of requirements. They can be biological ones, mechanical and aesthetics. In biological requirements we need to protect the pulp, we need to protect the periodontal health then there should be positional stability and we need to prevent the fracture okay in mechanical there is factors which is affecting the retention and the removal and removal of reuse then aesthetic we need to think about the color stability, color compatibility and translucency okay. So in biologic factor regarding the pulp protection, during tooth preparation the dental tribules are exposed. So this Provisional Restoration should protect the prepared tooth from oral environment okay we are protecting the tooth because it is reduced to an extent okay so there are chances of pulp damage so in order to prevent the tooth from any further damage by getting exposed to the oral environment so we are helping it to helping the tooth to get protected from the oral environment because of there is chances of sensitivity and irritation to pulp. So regarding the periodontal health so it should have good marginal fit should have proper contour and smooth surface to prevent any accumulation of plague or so it should easily cleanseable areas or it should facilitate easy plaque removal and should maintain good periodontal health. Now we have the positional stability so it should provide a comfortable stable and functional occlusion relationship by maintaining the inter arch and intra arch stability thereby preventing the tooth migration or prevention because if we have a prepared tooth here okay this is a prepared one and we have two adjacent tooth so it will not be like this okay this is normal adjacent tooth and we have the oppressing teeth here so what happens is if provisional restoration is not given there are chances of movements okay there are chances of migrations slight migration is there so when we place our final restoration it will not get fit properly okay so if we providing a provisional restoration all this space can be maintained that is intra arch and inter arch movements can be prevented by providing a provisional restoration okay now prevention of fracture so any provisional restoration definitely will prevent the fracture of the prepared tooth so this was the biology consideration now regarding the mechanical requirements so it should first one is a functional one it should process good compressive and flexural strength the strength of the material used for fabricating provisional restoration is always lower than that of the final one because it is not for a longer period it just for a shorter period so we don't need to have a good compressive strength or flexural strength but it should have a minimum strength to withstand the occlusion forces for the time being and regarding the retention so it should have close adaptation to the prepared tooth surface to prevent displacement and resimentation so which will increase patient visits now removal and removal of reuse so provisional restoration may need to be removed and resimented often so if they are well fabricated with adequate thickness and cemented with weak cement it can be removed without any breakage now regarding the aesthetics to basically the color and translucency so it should match the shape size the color texture of the restored tooth especially in the anterior region because aesthetics is most a bigger concern in the anterior part and the occlusion is bigger concern in the posterior part occlusion forces so color stability is also important if the provisional art to function for a prolonged period okay and it also serves as a guide to achieve aesthetics to final restoration now we can have a classification it can be classified based on the fabrication based on the material used according to the duration of use or according to the technique of fabrication so as per the fabrication it can be preformed or custom made as per the material we can use a resin or a metal resin we can have polycarbonate or cellulose acetate or custom made we have acrylics or base acrylic composites in metal we have preformed or custom made aluminum tin silver nickel chromium and all according to the duration of use it can be a short term one or a long term one and the technique can be a direct indirect or a combination so what should be the ideal requirements of a provisional restorative material okay so this material should have adequate strength and wear resistance it should be biocompatible it should have good dimensional stability and it should be easy to contour and polish it should be easy to repair and it should be orderless and non-irritating and it should be chemically compatible with the looting agent and it should have adequate working and setting time okay so what are the techniques of fabrication so we have basically three techniques there one is a direct one then the indirect technique and the combination of direct and indirect so in the first technique that is a direct technique like these pictures so we have the pre-op picture then we have the RPD in position that is the lateral incisor is to be replaced so we are taking support from the central incisor and the canine okay so first we have the RPD here so we take a putty index impression along with RPD okay so we are keeping RPD also in the impression that is a putty impression okay then we have the putty index with the removal partial danger and the flanges are trimmed then we prepare the tooth then what we do is we apply separating media on the prepared tooth okay then the resin is mixed and poured into the index on this putty impression then we keep it back to the prepared tooth and the idangelo space in position okay so index reseater in the mouth and let it allow to set the resin with RPD in the index so finally we get this and we trim it accordingly and use it as a provisional restoration this is a direct technique but the indirect technique is different so the direct technique is directly in the mouth okay so that is why it is a direct technique but this is outside the mouth we are doing it on the patience cast patience cast that is why it is indirect method so in indirect method the first step is the diagnostic cast with missing mandible incisor so we are replacing the missing mandible incisor so then the artificial teeth is arranged in the cast then we use the articulator and the cast with artificial teeth a vacuum is created then the tooth preparation is done then the cast following the tooth preparation so we do the same on the cast and we create a template on the cast to check the fit of the restoration then the template seated on the cast filled with the provisional restoration so we apply this material on the cast so in the cast the provisional restoration is being made so the template is removed from the cast after the polymerization process then we can trim it accordingly so that it fit to the prepared tooth and the missing place accurately so this is entirely done on the cast okay so we create a template on the cast and we do it outside okay that is why it is one as indirect technique whereas the combination direct indirect method some procedures are being taken place outside the mouth that is in the cast and some are in the patient's mouth so the first step is on the diagnostic cast the idangelous areas are restored and wax corrections are done then the patty index is created and the tooth preparation is done on the cast then the polymerizing acrylic resin is poured into this index then the index is secured on the cast by the rubber band so this indirect provisional restoration trimmed and fit on the cast okay so after that the abortment teeth is prepared in the patient's mouth then this acrylic resin is added to the retainer in the provisional restoration so the created provisional restoration we pour the acrylic resin and then we place it the place it the same with the poured acrylic resin into the patient's mouth and lastly the provisional restoration is done so it involves both the process that is a direct technique at the last steps inside the patient's mouth and the entire technique that is being happened in the cast we prepare okay so that is why known as direct and indirect technique after that we need to think about the cementation the cement should be having good properties like low solubility chemical compatibility or ease of eliminating the excess material basically the cement uses zinc oxide uh eugenol then uh the non-eugenol cements also can be used zinc phosphate polycarboxylate or GAC are not used because uh it is very difficult to remove for the final fixation okay so what are the limitations of provisional restoration one thing is a lack of adequate strength so the fracture of provisional restoration is possible in long span FPDs okay or the patient with bruxism and reduced interoclonal clearance and there will be inadequate marginal adaptation and there will be poor aesthetics and there will be chances of plague accumulation there will be compromised bonding and chances of mild to moderate tissue irritation okay so that was all about uh temporization or provisional restoration so it's very commonly asked short note so first we need to write the definition then the classification then about the ideal requirements of the material then the three techniques that is direct indirect and a combination technique and the rationale of temporization why exactly uh then what is the need of temporization or a provisional restoration okay so hope you understood this small topic you don't need to write in detail about all these techniques only you can just make use of a flow chart how the steps are being done because it won't be asked mostly it won't be asked for a long I said it will be a short note so we won't have time to explain everything step by step so you can follow a flow chart a small flow chart how this is being done okay hope you understood this I'll come up with a new topic in industry and more thank you