Provisional restorations.
A provisional protects the tooth, holds its position, maintains function, shapes the tissue and tests the plan. On a long or complex case, that is more than a chairside restoration can reliably do.
What the laboratory can make
Straightforward temporaries, temporaries with a cast substructure for extra rigidity, wire-reinforced provisionals, and ribbon-reinforced designs where a span needs strengthening without a full cast framework.
The reinforcement options matter on longer spans and in patients with heavy function, where an unreinforced acrylic provisional fractures at the connector and does so at an inconvenient moment.
For single units over short periods, a well-made chairside provisional is usually adequate. The laboratory options earn their place when the case will run longer or the span is greater.
Match the provisional to the timescale
Where a case is staged over months — periodontal treatment, orthodontic movement, implant integration, a vertical dimension being tested — the provisional has to survive that period without failing.
A provisional adequate for a fortnight becomes a liability over months: it debonds, wears through, allows adjacent teeth to drift, or irritates the tissue enough that the margin cannot be assessed cleanly at delivery.
Plan it to the actual timescale rather than an optimistic one. The cost difference is small against the disruption of a failure mid-treatment.
Contour and margin are not optional details
Teeth drift when contact is lost, measurably within a fortnight in some patients. A provisional with no proximal contact, or a light one, allows the adjacent teeth to move — and the definitive restoration is then made to a relationship that no longer exists.
An overextended, short or rough margin produces gingival inflammation within days. By the delivery appointment the tissue is swollen and bleeds readily, the margin cannot be assessed and the field cannot be controlled for cementation.
Both are entirely preventable and both are common.
The provisional as a design document
On complex cases the provisional stops being temporary and becomes a prototype. It establishes the vertical dimension, the occlusal scheme, the incisal edge position, tooth proportions and emergence — all tested in the mouth rather than on an articulator.
If it has been adjusted to work, those adjustments are the plan. Record it before it comes out: a scan, an impression, or photographs with a note on what was changed and why.
Send that with the definitive case and say explicitly that the restoration should reproduce the provisional. See provisional restorations explained.
Cementation
A provisional cemented too firmly is difficult to remove and risks damaging the preparation. One cemented too loosely debonds, allows the tooth to move, permits ingress at the margin and irritates the tissue.
Where adhesive cementation is planned for the definitive restoration, use a eugenol-free provisional cement — eugenol residue can interfere with resin polymerization.
Remove all provisional cement residue before the definitive restoration is seated. Residue at the margin prevents complete seating and compromises the bond wherever it remains.
What a failing provisional is telling you
Repeated debonding indicates inadequate retention on the preparation, or a cement chosen for easy removal on a preparation that needed more.
Wearing through or perforating occlusally indicates insufficient clearance — which is a warning about the definitive restoration rather than a provisional problem, because the definitive will occupy the same space.
Fracture at a connector suggests the span or connector dimension will be marginal in the definitive restoration too. In each case the provisional is reporting something worth acting on rather than simply repairing.
What to put on the prescription
Say the restoration is provisional and state the reinforcement you want: plain, cast substructure, wire reinforced or ribbon reinforced. Mark the units on the design chart.
Give the expected duration and what the provisional is doing — protecting, shaping tissue, testing a vertical dimension, or holding position through a staged plan. That changes how it is built.
Note the shade and whether appearance matters. A provisional in a visible position deserves more attention than one on a second molar.
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Digital scans and conventional impressions are both accepted. Cases move by UPS and Purolator, and Fairmont works with practices throughout British Columbia and across Canada.