Q: I have some patients that need a crown but cannot quite afford one at this time. Do you have any recommendations for long-term provisional restorations?
A: This has always been a dental conundrum. The patient wants to save the tooth, yet we have no less expensive way to accomplish the treatment. We may have wanted to help the patient by reducing fees, but at the same time we are in business and lab-processed temporary crowns add an expense by requiring two visits and a lab fee. Another option has been the traditional acrylic or composite temporary and hoping the temporary survives until definitive treatment can be rendered.
A new option is available. DirectCrown has released a nanotechnology composite long-term temporary crown called the Natural 1 that allows you to fabricate a stronger temporary crown in one visit. The composite crown shell is heat and pressure cured.
The tooth is prepared, and alginate impressions are taken in a triple tray (I am currently using the Triodent Triotry Pros). Using silicone die material and some polyvinyl siloxane, models are fabricated and articulated into an articulating tray. Remove the trays and you have working models in very short time.
A Natural 1 crown shell is selected. The crown shells have windows on the mesial and distal to ensure good contact with the adjacent teeth. The crowns are then air abraded, and a bonding agent (supplied with the Natural 1 crowns) is applied to the sand-blasted interior of the crown and light cured. The appropriate composite color is placed inside the crown, which is then seated back on the model and articulated.
Remove gross excess of composite and light cure. You can now finish the temporary crown. The crown is tried in the mouth, final adjustments to the occlusion are accomplished, and the Natural 1 long-term temporary crown can be cemented. It took me about 45 minutes to finish the case.
Marty Jablow, DMD, lectures and consults extensively about integrating technologies into the modern dental practice (www.dentaltechnologycoach.com). If you've got a technology question for Dr. Jablow, send it to [email protected].
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