Predictable techniques for single provisional veneers
Fabrication of provisional restorations for veneers can be a time-consuming and difficult task. Bis-acryl resin temporary materials have become the material of choice for this important part of the smile design process. Here’s why.
Celin Arce, DDS, MS, FACP
Porcelain veneers are a very conservative treatment for changing the shape, shade, and contour of teeth without resorting to full-coverage restorations. These restorations rely upon the bond between enamel and the porcelain veneer.1-3 Fabrication of provisional restorations for veneers can be a time-consuming and difficult task. The minimal reduction typically done and fragility of the thin temporaries make the process even more challenging.4-6
Figure 1: Veneer preparation
This is an important step in the smile design process. The patient has specific expectations that need to be communicated, and there should be a test drive with provisional restorations to ensure proper esthetics and function prior to fabrication of the final porcelain veneers.7-8
Figure 2: Diagnostic wax-up
There are a number of techniques for veneer temporization. Some clinicians prefer using the shrink-wrap technique, where the provisional is made on the prepped teeth and not removed. This approach is acceptable but has the challenge of needing to remove any flash from the margins in the mouth with a bur without damaging the already impressed preparations.9
Figure 3: LuxaTemp Ultra injected into a PVS matrix
Bis-acryl resin temporary materials have become the material of choice for veneer provisionals due to excellent mechanical and optical properties, marginal adaptation, polishability, and favorable add-on properties. This article describes a direct-indirect technique for fabrication of provisional veneers.10
Figure 4: Removal of the matrix for trimming of excess material
A 26-year-old patient presented with an old composite veneer on tooth No. 9. Composite was removed and preparation for a new veneer was finalized (figure 1). All margins were in sound enamel. A putty matrix of the diagnostic wax-up was done using Honigum Pro Putty (DMG America) and light body to capture surface details (figures 2 and 3).
Figure 5: Provisional veneer
A bis-acryl temporary material was dispensed into the putty matrix to fill the facial surface (Luxatemp Ultra; DMG America). The filled matrix was inserted into the patient’s mouth (figure 4). The provisional veneer was removed from the patient, and excess material was trimmed extraorally with carbide finishing burs and polished (figure 5).
Figure 6: Cementation with TempoCem ID
After that, the tooth surface was spot etched, and the provisional veneer was cemented using dual-cure, clear, temporary luting agent (TempoCem ID; DMG America; figure 6). Excess material was removed, and occlusion was verified (figures 7 and 8).
Figure 7: Cleanup of excess cement
Direct fabrication of temporary veneers can be time-consuming. This technique allows the clinician to fabricate provisional veneers easily, quickly, and precisely. It creates a high-esthetic restoration that can satisfy patient needs and stay in place until final cementation with excellent gingival health, while allowing for easy removal.
Figure 8: Completed provisional veneer
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Celin Arce, DDS, MS, FACP, is a board-certified prosthodontist. He received his dental degree from University Latina of Costa Rica, and completed residency in advanced prosthodontics at the University of Alabama at Birmingham as well as a master of science in clinical dentistry. He is a diplomate of the American Board of
Prosthodontics and a fellow of the American College of Prosthodontists. He is currently an assistant professor in the Restorative Sciences Department at the University of Alabama at Birmingham School of Dentistry.