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Temporary coverage of anterior teethThomas M. Cooper, B.S., D.D.S.*University of Kentucky, College of Dentistry, Lexington, Ky.

A ter completion of full crown preparations, the problem of satisfying estheticrequirements severely limits the materials that can be used to make temporarycrowns for anterior teeth. This article will describe a technique in which a stainlesssteel anterior crown is used with a veneer of cold-curing acrylic resin to achieve thedesired contour and appearance.

A successful anterior temporary crown should : (1) protect the prepared tooth,(2) be esthetically acceptable, (3) maintain healthy gingival tissue, and (4) resistthe masticatory forces tending to unseat it.

In attempts to produce temporary crowns that are cosmetically acceptable, thegingival tissue is often abused. To maintain healthy gingivae after a tooth is preparedfor an anterior full crown is difficult, but a few extra minutes spent at this time willinsure firm, healthy gingivae when the restoration is completed.

Celluloid crown forms, preformed acrylic resin crowns, and autopolymerizing(cold-curing) acrylic resin crowns are used for temporary coverage of anterior teeth,Although all of these are esthetically acceptable, considerable effort is necessary toproduce an acrylic resin temporary crown that does not irritate the gingival tissue.Studies1 have shown that acrylic resin will shrink or expand seven times as muchas tooth structure for every degree of temperature change. This produces a pump-ing action when hot and cold liquids are ingested and the resulting percolationcauses marginal 1eakage.lThe technique to be described will result in temporary restorations that areesthetically acceptable, possessadequate strength, and do not traumatize the gingivaltissue.TECHNIQUE

Immediately after placement of the gingival retraction cord around the tooth,a Rocky Mountaint stainless steel anterior crown of proper gingiual size is selected.It is neither necessary nor desirable for this crown to contact the adjacent teeth.The crown should be undersized, so that a veneer of 0.75 mm. to 1.0 mm. of acrylic

*Assistant Professor.iRocky Mountain Corporation, Denver, Colo.

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Volume 22Number 1 Temporary conerage of anterior teeth 69

Fig. 2

Fig. 1. A stainless steel anterior crown is trimmed and the gingival part is contoured to fitthe tooth. The level of the free gingival margin is scribed on the labial surface of the steelcrown as a guide for trimming.Fig. 2. A stainless steel crown is stippled on the labial and proximal surfaces with a one-hllfround bur before the acrylic resin veneer is added.

Fig. 3. A body shade of tooth-colored resin is added to the stainless steel crown to mask themetal color. No attempt is made to produce a final crown contour at this time. An inci~alshade of acrylic resin is then added to produce the desired crown form.Fig. 4. Incisal shade of tooth-colored resin is added to the anterior temporary crown to pro-duce the contour for the contact area after trial seating of the crown.

resin can be added to it without producing an overcontoured temporary restoration.Proper gingival contour is established at this time with contouring scissors to pxo-duce a metal margin 1.0 mm. subgingivally. A No. 114 contouring plier is thenused to produce a snug-fitting gingival margin (Fig. 1). All gingival contouring iscompleted at this time, and the curvature of the free gingival margin is scribed onthe labial surface of the crown with an explorer. The Rocky Mountain stainless steelcrown is then removed from the tooth and the labial surfaces and proximal surfacesof the metal crown are stippled with a No. /2 round bur (Fig. 2).

While the crown is held with a cotton plier on its cingulum, a body shade of

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J. Pros. Dent.July, 1969

Fig. 5 Fig. 6

Fig. 5. The anterior temporary crown should be contoured and polished prior to cementation.Note that the acrylic resin veneer does not extend below the free gingival margin.Fig. 6. The lingual view of the veneered anterior temporary crown shows the extension ofthe acrylic resin to the cingulum area.Fig. 7. An anterior temporary crown made from a stainless steel crown with a veneer ofacrylic resin is not only esthetically satisfactory, but it is also by far the strongest and mostdurable of all full-coverage anterior temporary restorations. It may be used for temporarycoverage during construction of a permanent crown or to protect a fractured anterior toothfor young patients.

one of the cold-curing tooth-colored acrylic resins, such as Sevriton or Bon Fill,+is applied to the labial, incisal, and proximal surfaces of the crown (Fig. 3). Careshould be taken to prevent any of the resin material from flowing below the previ-ously scribed line which shows the free gingival margin. At this point, no attemptis made to produce a final contour of the crown. The acrylic resin should be allowedto harden while the final impressions of the preparation are being made.

With the crown held by the cingulum again, additional resin of an incisal shadeis added to the resin already on the crown. This will produce the desired crowncontour. The contact areas are developed by slightly overbuilding them and seatingthe crown for a few seconds to mold this part o f the acrylic resin (Fig. 4). Afterthe final contour has been developed, the temporary crown is polished with a diskand seated with a temporary zinc oxide and eugenol cement (Fig. 5). The narrow

*Claudius Ash Company, Niagara Falls, N. Y.tL. D. Caulk Company, Milford, Del.

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72 Cooper J. Pros. Dent.July, 1969tion is strong and esthetically acceptable, and produces less gingival irritation thanall-acrylic resin temporary crowns.References1. Skinner, E. W., and Phillips, R. W.: The Science of Dental Materials, Philadelphia, 1967,W. B. Saunders Company, pp. 229-230.2. Fusayama, T., Miyazawa, M., and Hosoda, H.: Relationship Between Crazing of AcrylicResin Fillings and Times of Finishing and Polishing, J. PROS. DENT. 16: 140-144, 1966.3. Podshadley, A., and Harrison, J.: Rat Connective Tissue Response to Pontic Materials,J. PROS. DENT. 16: 1 Obll8, 1966.4. Langeland, K., and Langeland L.: Pulp Reactions to Crown Preparation, Impression,Temporary Crown Fixation, and Permanent Cementation, J. PROS. DENT. 15: 129-143,

1965.UNIVERSITY OF KENTUCKY MEDICAL CENTERDEPARTMENT OF RESTORATIVE DENTISTRYLEXINGTON, KY. 40506