SSC Provisional Coverage

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SSC Provisional Coverage Provisional Coverage • Provisional Coverage is a temporary protective crown/bridge that is temporarily cemented to a tooth that has been prepared to revive a single crown,/ to the abutment teeth for a fixed bridge Indications for Provisional Coverage • Reduces sensitivity & discomfort of the prepared tooth • Maintains the functions & aesthetics of the prepared tooth • Protects the margins of the preparations • Prevents shifting of the adjacent/opposing teeth Types of Provisional Coverage • 2 types of Provisional Coverage commonly used Custom Provisional Coverage • The most common type of temporary coverage for crown & Bridge preparations • These shell-like crowns are available for single unit teeth • When several teeth have been prepared,/ when a multi-unit bridge is being created, a laboratory can be complete the provisional prosthesis Aluminum Crowns (SSC) • Designed specifically for premolars & molars ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Armamentarium for SSC Restorations • Clinical Procedure • Tooth Preparation • Crown Preparation • Modifications of SSC • Complications • Conclusion • Burs • Pliers (Crimpers) • Instruments • Cementing Medium • Polishing & Isolating Indications for SSC • After a pulpotomy/pulpectomy specially the first primary molar. High incidence of amalgam isthmus fracture • When 3/more surfaces need restoration • As an abutment for fixed appliances • High caries index patient • During general anesthesia full mouth rehabilitation Contradictions of SSC • If the primary molar is close to exfoliation w/ more than half the roots resorbed/exfoliated within 6–12 months • Tooth exhibits excessive mobility • Partially erupted teeth • Where conservative restorations can be placed • In a patient w/ known nickel allergy Tooth Preparation • The aims of the tooth reduction are: • The crown is tried on the tooth by seating the lingual first & applying pressure in the buccal directions, so that the crown slides over the buccal surface into the gingival sulcus ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Crown Adaptation • Try crown on tooth: Lingual to Buccal • Mark scratch line • Cut 1mm below it w/ scissors • Place the crown again: • If the crown is excessively long, the crown margin may impede complete seating, in which case crown length may be adjusted by trimming w/ crown shears & resmoothing & polishing the edges w/ an abrasive stone • Over trimming of the crown margin should be avoided, as it may affect retention if it results in reduced adaptation of the crown margin into undercut areas Crimping • Mechanical retention • Protection of cement from exposure to oral fluids • Maintenance of gingival health Finishing • Retention problems do not cause failure of the steel restoration • Most failures result from poor & inadequate preparation, improper gingival adaptation, & the inability to properly visualize & determine the relationship of the crown margin to the margin of the preparation Cementation • Among all the cements used for cementation, the GIC was found quite new & very promising • Glass ionomer cement are quite new & very promising. These cements have comparable strength w/ Zinc Phosphate, release fluoride as do the silicophosphate, chelate/bond to tooth structure as the polycarboxylate & are as pulpally compatible as the polycarboxylates • They could prove to be the best cement available for SSC cementation SSC for Permanent Molars • Indications: ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Removal of the Provisional Crown/Bridge • It is essential that a provisional crown/bridge remains cemented while the fixed prosthesis is being prepared & delivered to the dental office • When the patient returns for the final cementation of a fixed crown/bridge, the Provisional should be cautiously removed w/o harm, just in case it needs to be recemented if the final prosthesis need to be sent back to the laboratory for adjustments & remake Home Care Instructions for Provisional Coverage • Should be provided both verbally & in writing • Bite & chew carefully, & avoid sticky foods • When flossing, do not “pop” the floss in & out of contact; once the floss is placed below the contact, pull the floss through the contact to the lingual/facial side • If the provisional coverage is loose/lost, contact the office immediately to have it replaced Conclusion • The judicious combination of one of the various tooth preparation techniques mentioned by various research workers & proper manipulation of the metal crown in skillful hands, along w/ continuous improvements which have been made in the anatomic configuration of the crown, would lead to a wonderful restoration w/ high durability