Better Fitting Provisionals in One Easy Step

We all strive to make our provisionals fit as well as we can. Improved fit of our provisional restorations reduces tooth sensitivity and increases tissue health, thereby leading to a more efficient delivery of the definitive restoration. Today, the most common material used to fabricate provisional restorations is a Bis-acryl composite. If you use this type of material, one easy step to help improve the marginal fit of your provisional restorations is to physically remove the air-inhibited layer that develops on the "internal" of the provisional.

For years my protocol for trimming a provisional restoration has been to first clean the provisional in alcohol prior to starting the adjustment process. This helps to remove the air-inhibited layer and make the adjustment process more efficient without clogging up the bur. After completing the adjustment of the provisional with burs and disks, I would air abrade the internal of the provisional with a sandblaster.

This process helped me achieve a very nice marginal fit. However, I believe the fit of my provisionals is now even better. What I have started to do to help improve the fit of my provisional restorations is to manually scrape the internal of the provisional with a hand instrument prior to air abrasion.

As you can see by the photo, this additional step removed a fairly significant amount of material that is not fully cured and isn't removed by air abrasion. Removing this material with a hand instrument enables a more "passive" and complete seat of the provisional restoration on the tooth, thereby leading to a better fit. Try this on your next provisional restoration and you too will see how it will help improve the marginal fit.